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Publication numberCN101883528 B
Publication typeGrant
Application numberCN 200880106148
PCT numberPCT/US2008/075449
Publication date23 Oct 2013
Filing date5 Sep 2008
Priority date6 Sep 2007
Also published asCN101883528A, CN103690211A, CN103690211B, EP2182861A2, EP2182861A4, EP2182861B1, EP2742880A1, US7954683, US7963432, US7988026, US8272551, US8439245, US8679155, US8789738, US9144427, US9655618, US20090065552, US20100230464, US20110210157, US20110284613, US20110309127, US20120097731, US20130240603, US20140207165, US20150265277, WO2009033057A2, WO2009033057A3, WO2015142360A2
Publication number200880106148.6, CN 101883528 B, CN 101883528B, CN 200880106148, CN-B-101883528, CN101883528 B, CN101883528B, CN200880106148, CN200880106148.6, PCT/2008/75449, PCT/US/2008/075449, PCT/US/2008/75449, PCT/US/8/075449, PCT/US/8/75449, PCT/US2008/075449, PCT/US2008/75449, PCT/US2008075449, PCT/US200875449, PCT/US8/075449, PCT/US8/75449, PCT/US8075449, PCT/US875449
Inventors布赖恩D.克诺德, 伯纳德A.豪森, 卢克W.克劳森
Applicant卡迪卡公司
Export CitationBiBTeX, EndNote, RefMan
External Links: SIPO, Espacenet
Endocutter with staple feed
CN 101883528 B
Abstract  translated from Chinese
一外科手术用内切割器可以包含一端部执行器,至少部分延伸至端部执行器的至少一供给带,两个或更多个缝钉,其中每一缝钉有一易断性连接对应的供给带的第一末端和一自由的第二末端,其中缝钉形成至少一排。 Within a surgical cutter actuator may comprise an end portion, extending at least partially to the end of the actuator is supplied with at least one, two or more staples, wherein each staple has a frangible connection corresponding supply a second end with a first end and a free, which form at least one row of staples. 内切割器可以通过开口,如套针孔将端部执行器插入病人体内,用端部执行器夹住组织,通过端部执行器沿着两条缝钉线缝钉组织,在缝钉线之间切割组织,从端部执行器上放开组织,在病人体内不同位置重复抓住,缝钉和夹紧组织,而不需要从病人体内取出端部执行器,从而对病人进行治疗。 Endocutter through the opening, as set pinhole will end effector inserted into a patient tissue clamped by the end effector, through the end effector along two lines of staples staple tissue in the staple line between cutting tissue, tissue from the open end of the actuator, repeated in different locations to seize patient, staples and clamp tissue, without the need to remove the end effector from the patient, so the patient treatment.
Claims(19)  translated from Chinese
1.一种外科手术用内切割器,包含: 一缝钉盒; 至少一可推进和拉回的供给带,该供给带带有两个侧边缘,所述供给带至少局部延伸至所述缝钉盒;和多个缝钉,其中每一所述缝钉包含与对应的所述供给带易断性连接的第一端,其中每一所述第一端在相对于供给带纵向中心线的基本相同的侧面位置被附着于所述供给带,和第二自由端,并且其中,所述缝钉形成至少一排,每排包含至少两个缝钉,其中至少一个所述缝钉被附着于所述供给带并位于与所述供给带垂直的平面上,或所述至少一个缝钉是位于与所述供给带成不同角度的平面上。 A surgical inner cutter, comprising: a staple cartridge; at least one can be supplied with propulsion and back, the two side edges with tape supply, the supply belt extending at least partially to the seam staple cartridge; and a plurality of staples, wherein each of said staples comprising corresponding first end of said supply tape easily broken connection, and wherein each of said first end with respect to the longitudinal centerline of the supply substantially the same position is attached to the side of the supply belt, and a second free end, and wherein said forming at least one row of staples, each row comprising at least two staples, wherein at least one of the staple is attached to The supply belt and located at least one staple with the supply belt vertical plane, or said is located on the supply belt to the plane at different angles.
2.如权利要求1所述的外科手术用内切割器,其中每一所述缝钉的方向基本垂直对应于所述供给带。 2. The surgical claim 1, wherein the cutter, wherein each of said staple is substantially perpendicular to a direction corresponding to the supply belt.
3.如权利要求1所述的外科手术用内切割器,其中在至少一所述排中的多个所述缝钉集合成多个组,且其中对应的所述供给带包含相邻的所述组间的空白区。 3. The surgical claim 1, wherein the cutter, wherein at least one of said plurality of rows of said plurality of groups grouped into staple, and wherein said corresponding tape comprising supplying the adjacent blank area between the above groups.
4.如权利要求1所述的外科手术用内切割器,其中至少一排缝钉与对应的所述供给带的对应的所述侧边缘易断性连接。 4. The surgical 1 according to the claim as a cutter, wherein the at least one corresponding row of staples of the corresponding side edge of the tape supplying frangible connection.
5.如权利要求1所述的外科手术用内切割器,其中至少一排缝钉沿着位于所述供给带的所述侧边缘之间的线与对应的所述供给带易断性连接。 5. The surgical claim 1, wherein the cutter, wherein the at least one row of staples is located along the supply line supplying the corresponding side edge of the tape between the tape frangible connection.
6.如权利要求1所述的外科手术用内切割器,其中至少一所述排的所述缝钉与至少另一所述排的所述缝钉错开排列。 6. The surgical claim 1, wherein the cutter, wherein at least one of said rows of staples and at least one other of said rows of said staggered staples.
7.一种外科手术用内切割器,包含:` 一缝钉盒; 至少一可推进和拉回的供给带,其中该至少一供给带的至少局部延伸至所述缝钉盒; 多个缝钉,该缝钉与每一所述供给带易断性连接,所述缝钉在每一所述供给带上组成至少一条大体为直线的排; 多条楔,其中每一条楔能沿着对应的所述缝钉排从初始位置基本直线移动到第二位置,从而使所述缝钉变形且与对应的所述供给带分离。 A surgical inner cutter, comprising: a staple cartridge `; at least one can be supplied with propulsion and back, wherein the at least one supply belt extending at least partially to the staple cartridge; a plurality of slits nails, staples and each of which is supplied with the frangible connection, the staple in each of the supply belt composed of at least one substantially straight row; a plurality of wedges, each of which corresponds to a wedge can along the rows of staples substantially linearly from an initial position to a second position, such that the staple deformed and supplying the corresponding band separation.
8.如权利要求7所述的外科手术用内切割器,其中所述楔沿着固定距离移动。 7 with the surgical device 8. The inner cutter as claimed in claim wherein said wedge moving along a fixed distance.
9.如权利要求7所述的外科手术用内切割器,其中所述楔沿着可选择距离移动。 9. The use as claimed in the surgical cutter according to claim 7, wherein the wedge is moved along the selectable distance.
10.如权利要求7所述的外科手术用内切割器,其中所述缝钉盒包含一弯曲的突出部,其中每一所述供给带均设置成围着对应的所述突出部推进;且其中每一楔可在所述供给带推进前回移至所述初始位置。 10. The use as claimed in the surgical cutter according to claim 7, wherein the staple cartridge comprises a curved protruding portion, wherein each of said supply tape are arranged around the projecting portion of the corresponding propulsion; and wherein each wedge may be moved back to the initial position before the supply belt advance.
11.如权利要求7所述的外科手术用内切割器,进一步包含至少一个对应于至少一个所述供给带的滑动夹具,其中所述滑动夹具滑动至接触所述供给带。 11. The surgical claim 7, wherein the cutter further comprises at least one of said at least one corresponding sliding fixture supply tape, wherein said slide clamp to slide in contact with the supply.
12.如权利要求11所述的外科手术用内切割器,其中至少一个滑动夹具包含一个上夹具和相互接触的下夹具,每一夹具都包含一凸轮表面,其中至少一个所述上夹具和所述下夹具相对于另一个滑动,从而使所述凸轮表面间相衔接,引起所述上夹具移动至接触所述供给带。 12. The surgical claim 11, wherein the cutter, wherein at least one slide clamp comprising an upper jig and lower jig in contact with each other, each of the clamps include a cam surface, wherein at least one of said upper jig and the said lower jig slide relative to one another, so that the cam surface of convergence between, causing the clamp to move contacts on the supply belt.
13.—种外科手术用内切割器,包含: 一带有内部空间的缝钉盒;与所述缝钉盒连接的杆轴,所述杆轴包含一个贯通的腔; 与所述杆轴相连的手柄; 与多个缝钉易断性连接的至少一个可推进和拉回的供给带,其中至少一个所述供给带的至少局部位于所述缝钉盒空间内和所述杆轴的腔内,使得所述缝钉位于所述缝钉盒和所述杆轴内。 13.- species within the surgical cutter, comprising: an internal space with a staple cartridge; lever shaft and connected to said staple cartridge, the lever comprises a shaft lumen therethrough; shaft connected to the lever a handle; a plurality of staples frangible connection to at least one advancing and retracting the supply belt, wherein at least one of said supply belt is located at least partially within the staple cartridge chamber space and the shaft of the rod seam, such that the staples in said staple cartridge and said inner shaft rod.
14.如权利要求13所述的外科手术用内切割器,其中所述缝钉盒设置为部署少于全部的所述缝钉,且其中所述缝钉的剩余部分之后被推入所述缝钉盒的所述空间内。 14. The surgical claim 13, wherein the cutter, wherein the staple cartridge is set to less than all of the deployment of the staple, and wherein after the remaining portion of the staple is pushed into the slit The inner space of the cartridge.
15.如权利要求13所述的外科手术用内切割器,其中所述供给带延伸至所述手柄。 15. The surgical claim 13, wherein the cutter, wherein the tape supply extend to the handle.
16.如权利要求15所述的外科手术用内切割器,其中所述供给带是一个连续的环状物。 16. The surgical claim 15, wherein the cutter, wherein said supply belt is a continuous ring.
17.如权利要求13所述的外科手术用内切割器,其中所述缝钉盒与所述杆轴是不可分离的。 17. The surgical claim 13, wherein the cutter, wherein said staple cartridge and said lever axis are inseparable.
18.—种外科手术用内切割器,包含: 至少一可推进和拉回的供给带; 与所述供给带易断性连接的多个缝钉;和相对于所述缝钉移动的至少一个楔,其中所述楔在一单一连续的运动中和多个所述缝钉连接又将多个所述缝钉从所述供给带上分离出来。 18.- species within the surgical cutter, comprising: at least one can be supplied with propulsion and back; and a plurality of said supply tape easily broken connected staples; and a relative movement of the at least one staple wedge, wherein the wedge in a single continuous movement and in turn connected to a plurality of said plurality of staples staples tape is separated from the supply.
19.如权利要求18所述的外科手术用内切割器,且其中至少一个所述楔连续衔接所述缝钉并将所述缝钉从所述供给带上连续分离出来。 19. The surgical claim 18, wherein the cutter, and wherein at least one of said continuous engagement of the wedge and the staples from the staple feeding belt continuously separated.
Description  translated from Chinese

能够供给缝钉的内切割器 Staples can be supplied within the cutter

技术领域 Technical Field

[0001] 本发明主要涉及一种外科手术工具及方法。 [0001] The present invention generally relates to a surgical instrument and method. 更具体地说,本发明涉及一种内切割器。 More particularly, the present invention relates to a cutter.

[0002] 技术背景 [0002] Technical Background

[0003] 内切割器是一种用于缝钉和切割组织,从而横切该组织并能对切割末端止血的外科手术工具。 [0003] The inner cutter for a staple and cut tissue, thus the tissue and is able to cross the cutting tip hemostatic surgical tool. 其直径很小,足以应用于微创手术中,可以通过套针,插孔,或者身体上的小切口达到手术部位。 Its diameter is small enough to be applied to minimally invasive surgery, you can trocar, jack, or a small incision on the body to reach the surgical site. 线型的切割器属于大型的内切割器,用于横切胃肠道部分。 Linear cutter is a large endocutter for cross-section of the gastrointestinal tract. 内切割器末端通常带有一个可拆卸的单用途带装有几排缝钉的钉仓,钉仓对面有一个砧。 Endocutter end usually comes with a removable belt fitted with several rows of single-use staples cartridge, the cartridge has an anvil opposite. 外科医生通过套针或者其它插孔或者身体上的切口将内切割器插入体内,将内切割器末端指向需要横切的组织的方向,同时压迫砧和钉仓以夹紧组织,然后将一排或几排缝钉部署在横切线的一边,刀口沿着横切线推进将组织切开。 Surgeons cut through the trocar or other receptacle or body will endocutter inserted into the body, the inner cutter end points in the direction transverse to the needs of the organization, while repression to clamp the anvil and cartridge tissue, then a row or several rows of staples deployed in side cross the line, edge line along the transverse incision to promote the organization.

[0004] 在内切割器的驱动过程中,钉仓中的缝钉将被全部用完。 Driven process [0004], including the cutter, a staple cartridge of staples will be fully utilized. 为了装填更多的缝钉,必须从手术部位及病人体内取出内切割器,之后才能将旧钉仓更换成新钉仓,然后内切割器被再次插入病人体内。 For filling more staples must be removed from the surgical site and patient endocutter before you can will replace the old cartridge with a new cartridge, and then inside the cutter is inserted into the patient again. 然而,再次插入后要确定手术部位是很困难的也是很费时间的。 However, after inserting it again to determine the surgical site it is very difficult also very time-consuming. 另外,每次使用后从病人体内取出内切割器,更换钉仓,之后再次确定手术部位的过程很繁琐,不便且很花时间,特别是对于那些需要多次使用内切割器的外科手术。 In addition, the process is removed from the patient after each use inside the body of the cutter, replace the cartridge, and then again to determine the surgical site is very cumbersome, inconvenient and takes a lot of time, especially for those who require multiple surgical procedures using endocutter. 这些不便使外科医生不愿意在这些步骤中使用内切割器,即使使用这些内切割器对病人是有益的。 These inconveniences make surgeons are reluctant to use the cutter in these steps, even if the inner cutter is beneficial to the patient.

[0005] 附图说明`[0006] 图1是一内切割器的示意图。 [0005] BRIEF DESCRIPTION `[0006] Figure 1 is a schematic view of an inner cutter.

[0007] 图2是病人身体上一个套针孔的剖面图。 [0007] FIG. 2 is a sectional view of a sleeve on a patient's body pinhole.

[0008] 图3是病人身体上多个套针孔的剖面图。 [0008] FIG. 3 is a sectional view of a plurality of sets of pinholes on the patient's body.

[0009] 图4是一易断性连接有三排缝钉的供给带的实施例透视图。 [0009] FIG. 4 is a frangible connection perspective view of a conventional example embodiment of the three rows of staples with the supply.

[0010] 图5是图4所示供给带的侧视图。 [0010] FIG. 5 is a side view of the supply belt 4 shown in FIG.

[0011] 图6是图4所示供给带的俯视图。 [0011] FIG. 6 is a top view shown in Figure 4 is supplied with.

[0012] 图7是使用图4-6所示供给带的内切割器端部执行器的实施例的侧视图 [0012] FIG. 7 is a side view of an embodiment using the actuator is supplied with an inner end portion of the cutter illustrated in Figures 4-6

[0013] 图8是一供给带引导器实施例的透视图。 [0013] FIG. 8 is a perspective view of the supply belt guide embodiment.

[0014] 图9是不带有供给带的图8所示的供给带引导器侧面剖视图。 [0014] FIG. 9 is a sectional view of the supply side tape guide shown in Fig. 8 without the supply of tape.

[0015] 图10是带有供给带的图8所示的供给带引导器侧面剖视图。 [0015] FIG. 10 is a sectional view of the supply side tape guide shown in FIG. 8 with supply tape.

[0016] 图11是图7所示端部执行器实施例的缝钉盒外壳实施例透视图。 [0016] FIG. 11 is a view of an end portion of the actuator 7 staple cartridge housing a perspective view of an embodiment example embodiment.

[0017] 图12是图7所示端部执行器实施例的剖面图(perspective cutaway view)。 [0017] FIG. 12 is a sectional view (perspective cutaway view) end of the actuator portion shown in FIG. 7 embodiment.

[0018] 图13是一楔部件实施例的透视图。 [0018] FIG. 13 is a perspective view of a wedge member embodiment.

[0019] 图14是图7所示端部执行器实施例的模块实施例的透视图。 [0019] FIG. 14 is a view of an end portion of the actuator 7 shown in a perspective view of an embodiment of the module according to embodiments.

[0020] 图15是一切割器实施例的透视图。 [0020] FIG. 15 is a perspective view of an embodiment of the cutter.

[0021] 图16是图7所示端部执行器实施例的侧面剖面图。 [0021] FIG. 16 is a side cross-sectional view of an end portion of the actuator shown in FIG. 7 embodiment. [0022] 图17是图7所示端部执行器实施例的夹持器透视图。 [0022] FIG. 17 is a perspective view of an end portion of the holder shown in FIG. 7 embodiment of the actuator.

[0023] 图17A是图17所示夹持器底面透视图。 [0023] FIG. 17A is a perspective view of the bottom surface of the holder 17 shown in FIG.

[0024] 图18是易断性连接有两排缝钉的供给带的实施例透视图。 [0024] FIG. 18 is a frangible connection perspective view of a conventional example two rows of staples supply belt.

[0025] 图19是图18所示供给带的侧视图。 [0025] FIG. 19 is a side view of the tape supply 18 shown in FIG.

[0026] 图20是图18所示供给带的俯视图。 [0026] FIG. 20 is a plan view of Figure 18 with the supply.

[0027] 图21是使用图18-20所示供给带的内切割器的端部执行器的实施例侧面剖视图。 [0027] FIG. 21 is a side cross-sectional view of an embodiment of the cutter actuator is supplied with the end portion shown in Figures 18-20 use.

[0028] 图22是图21所示端部执行器实施例的缝钉盒外壳的实施例透视图。 [0028] FIG. 22 is a perspective view of the embodiment of the staple cartridge housing an end portion of the actuator shown in FIG. 21 embodiment.

[0029] 图23是图21所示端部执行器实施例的模块透视图。 [0029] FIG. 23 is a perspective view of the module of the end effector shown in FIG. 21 embodiment.

[0030] 图24是图21所示端部执行器实施例在邻近模块时的详细剖视图。 [0030] FIG. 24 is a detailed cross-sectional view of the module at the end portion adjacent the actuator 21 shown in FIG embodiment.

[0031]图25是另一种易断性连接有两排缝钉的供给带实施例的透视图。 [0031] FIG. 25 is another frangible connection a perspective view of an embodiment of the two rows of staples is supplied with.

[0032] 图26是图25所示供给带的侧视图。 [0032] FIG. 26 is supplied with a side view of FIG. 25.

[0033] 图27是图25所示供给带的俯视图。 [0033] FIG. 27 is a plan view of the supply belt 25 shown in FIG.

[0034] 图28是楔部件另一实施例的远末端透视图。 [0034] FIG. 28 is a perspective view of the distal end of another embodiment of the wedge member.

[0035] 图29是一被内切割器横切的血管的透视图。 [0035] FIG. 29 is a perspective view of an inner cutter is transected blood vessels.

[0036] 图30是可滑行夹`具的透视图,其中每一夹具都处在相对于对应供给带的第一位置。 [0036] FIG. 30 is a perspective view of a slide clamp 'FIG wherein each clamp is in a first position relative to the band corresponding to the supply.

[0037] 图31是图30所示可滑行夹具的侧视图,其中每一夹具都处在相对于对应供给带的第一位置。 [0037] FIG. 31 is shown in FIG. 30 can slide in the side view of the clamp, wherein each clamp is in a first position relative to the band corresponding to the supply.

[0038] 图32是图30所示可滑行夹具的透视图,其中每一夹具都处在相对于对应供给带的第二箝位。 [0038] FIG. 32 is a perspective view of the slide 30 may be illustrated clamp, wherein each clamp are supplied in a tape relative to the corresponding second clamp.

[0039] 图33是图30所示可滑行夹具的侧视图,其中每一夹具都处在相对于对应供给带的第二箝位。 [0039] FIG. 33 is shown in FIG. 30 can slide in the side view of the clamp, wherein each clamp are supplied in a tape relative to the corresponding second clamp.

[0040] 相同参考符号在不同的附图中代表相似或相同的部件。 [0040] Like reference symbols in different drawings represent similar or identical elements. 详细描述内切割器-三排缝钉 Detailed Description endocutter - three rows of staples

[0041] 如图1所示,一内切割器2包括一与杆轴6连接的端部执行器4,该杆轴6继而与手柄8连接。 [0041] 1, 2 includes an inner end portion of the cutter actuator lever shaft 6 is connected with one of the four, then the lever shaft 6 is connected with the handle 8. 端部执行器4可以是一个或多个与杆轴6连接的独立的部件或者是与杆轴6远末端整体制作的部件。 End actuator 4 may be connected to one or more of the lever shaft 6 independent member or shaft 6 with the distal end of the rod member integrally made. 又如图2-3所示,端部执行器4和杆轴6的尺寸可制作成能通过位于病人14的组织12上的标准的套针孔10。 Another example is shown in Figure 2-3, the size of the end effector 4 and the lever shaft 6 can be made into the patient through a standard 12 located on the organization's 14 sets pinhole 10. 有利的是,端部执行器4的尺寸应可通过开口直径为5-10毫米的套针孔10。 Advantageously, the size of the end effector 4 should be through an opening diameter of 5-10 mm pinhole 10 sets. 或者,内切割器2可以用于传统的不使用套针孔的开放式外科手术中。 Alternatively, the inner cutter 2 can be used without the use of conventional sets of pinhole open surgery. 另外,内切割器2可以用于微创手术,其可通过除套针孔以外的装置或结构到达手术位置,如Ethicon Endo-Surgery公司的LAP DISC手动进入装置,或者通过不安装套针孔或其它装置或结构的切口或开口到达病人体内的手术位置。 Further, the cutter 2 can be used for minimally invasive surgery, which can be a device or structure other than the pinhole sleeve reaches the surgical site, such as the LAP DISC manually Ethicon Endo-Surgery's access device, or by not mounting sleeve pinholes or other devices or structures incision or opening the patient reaches the surgical site.

[0042] 套针孔10是中空的,结构总体成管状,用于插入病人组织12的切口,使切口保持打开状态,并且防止因工具活动或其它物件穿过切口而造成的对切口周围组织12的损伤。 [0042] The cover pinhole 10 is hollow, generally tubular structure, organization notch 12 for insertion into a patient, so that the cut remains open and prevent tissue due to tool around the incision activity or other objects through the incision caused 12 damage. 套针孔10的材料可以是塑料或者其它合适的生物适合性材料。 Material sets pinhole 10 may be plastic or other suitable biocompatible material. 套针孔的横截面大体上是圆形、椭圆形或其它合适的形状。 Cross-section sets pinhole is substantially circular, elliptical or other suitable shape. 套针孔10的具体尺寸根据对病人即将实施的具体程序而定,可以是任何合适的尺寸。 Pinhole 10 sets specific dimensions according to specific procedures to be implemented depending on the patient, may be any suitable size. 套针孔10可以通过其中心与切割器(未显示)连接,切开组织12,然后放置于组织12。 Sleeve 10 may be connected through a pinhole and the center cutter (not shown), cut tissue 12, and then placed in tissue 12. 切割器可以是尖状物或者其它切割或穿孔设备。 Cutter may be spikes or other cutting or piercing equipment. 当套针孔10在胸壁放置到位后,切割器就从套针孔10移去。 When set pinhole 10 in place in the chest wall, the cutter will be removed from the set of the pinhole 10. 套针孔10和切割器的组合在本领域内是标准的。 A combination of 10 and cutter set pinhole is standard in the art.

[0043] 如图1所示,内切割器2的杆轴6自端部执行器4向近处延伸。 [0043] 1, the inner cutter bar shaft 2 from the end portion of the actuator 6 extends proximally as shown in Figure 4. 杆轴6可以是带弹性的或是刚硬的。 Lever shaft 6 can be rigid or resilient. 如果需要,杆轴6可以有至少一个铰接位置。 If desired, the lever shaft 6 may have at least one hinge location. 或者,杆轴6可以带有一切口,槽或其它特征(未显示),用于容纳可能用于手术程序中的导引线(如果有的话)或者其它用于定位的辅助工具,以使其在内切割器2驱动时保持原位置。 Alternatively, the lever shaft 6 may be provided with a notch, slot or other feature (not shown), may be used in surgical procedures for receiving the guidewire (if any) or other aids for positioning, so that Its inner cutter is driven to maintain the original position 2.

[0044] 手柄8可以与杆轴6近末端或其它合适的部位相连接。 [0044] handle 8 can be connected with 6 near the end or other suitable parts of the axle. 杆轴6可以与手柄8整体制作。 Lever shaft 6 can be made with the handle 8 overall. 或者,杆轴6和手柄8是两个独立的,可以通过任何一种合适的方式连接在一起的部件。 Alternatively, the handle lever shaft 6 and 8 are two independent components can be connected together by any suitable means. 手柄8包括任何经过适当的设置能驱动端部执行器4的一个或多个装置或者一个或多个结构。 After the handle 8 comprises any suitable driving end can be provided with one or more actuator means, or a 4 or more structures. 手柄8也可以带有驱动端部执行器4的能源存储器。 8 may drive the handle end with the actuator 4 of the energy storage. 能源存储器可以是机械的(如发条),电子的(如电池),风动的(如加压气体泵)或者任何其它合适的能源存储器。 Energy storage may be mechanical (e.g. spring), electrons (e.g. battery), pneumatic (e.g. pressurized gas pumps) or any other suitable energy storage. 能源存储器,对能源存储器的控制及其在驱动端部执行器4中的应用如2005年2月9日提交的美国专利申请11/054,265所述。 Energy storage, control and use of energy storage in the driving end of the actuator 4 as described in U.S. Patent February 9, 2005 filed the 11 / 054,265. 该申请作为参考被整体引用于此。 The application incorporated herein by reference in its entirety. 手柄8也可以包括一个或多个适合接收外源能源的连接装置,如与医院使用的加压气体或真空源连接的胶管,或者可与电源连接的电线。 Handle 8 may also include one or more attachment means adapted to receive external energy source, a vacuum source hose as pressurized gas or connection with hospitals, or wires can be connected to the power supply.

[0045] 如图4-6所示,供给带16的一部分被置于端部执行器4内。 Shown in [0045] Figures 4-6, with a portion of the supply end 16 is placed within the actuator 4. 供给带16可以是长的,狭窄的,薄的带状材料,一个或多个缝钉18可从供给带上延伸出来。 16 can be supplied with a long, narrow, thin strip of material, one or more of the staple 18 may extend from the supply belt. 供给带16可以是不锈钢,镍-钛合金或者任何其它合适的金属或者非金属材料。 16 can be supplied with a stainless steel, nickel - titanium or any other suitable metal or non-metallic materials. 供给带16有足够强的柔韧性及强度,能够在线性推进后,在突起部或者其它结构部位调转为基本上相反的方向,其具体内容将在下面详述。 Supplied with 16 strong enough flexibility and strength, after possible linear advance in protrusions or other structural parts turned substantially in the opposite direction, the specific details will be described in detail below. 另外,供给带16可以是刚硬的或者至少部分刚硬的,可以基本线性推进或拉回而不需沿一结构改变方向。 Further, the supply 16 may be a rigid band or at least partially rigid, or can be substantially linear propulsion retracted without structural changes along a direction. 每一个缝钉18都可以具有任何合适的形状;各缝钉18的形状可以基本一致或者各不相同。 Each staple 18 may have any suitable shape; the shape of each staple 18 may be basically the same or different. 例如,每一个缝钉18大致都是V形,并且带有两个从V形基底延伸出来的脚20。 For example, each staple 18 is substantially V-shaped and V-shaped with two extending from the base out of the pin 20. 如图5具体所示,缝钉18的一只脚20大致是直的,另一只脚20略微弯曲。 Specifically as shown in FIG. 5, a foot 18 of the staple 20 is substantially straight, the other leg 20 slightly bent. 然而,脚20的形状可以各不相同。 However, the shape of the feet 20 may vary. 另外,每一只脚20的形状也可以是相同的。 Further, the shape of each foot 20 may also be the same. 缝钉18不必是对称的,但如果需要,可以做成对称的。 Staple 18 need not be symmetrical, but if desired, can be made symmetrical. 缝钉18的V形基底可以是弯曲的,尖的或者其它构形`。 Staples V-shaped base 18 may be curved, pointed or `other configurations. 缝钉18的一只脚20有一自由端22,因其特征可称为组织穿透尖22。 A foot 18 of the staple 20 has a free end 22, its characteristics may be referred to tissue penetration tip 22. 如果需要,组织穿透尖22可以被削尖,从而帮助穿透组织。 If desired, the tissue-penetrating tip 22 may be sharpened to penetrate tissue to help. 然而,缝钉18的脚20有一个足够小的截面,使组织穿透尖22不需要削尖就能容易的穿透组织。 However, the staple legs 18, 20 has a sufficiently small cross-section, the tissue penetrating tip 22 does not need sharpening can easily penetrate tissue. 另外一只脚20的一端与供给带16连接。 The other foot 20 with one end of the supply 16 is connected. 有利的是,脚20和供给带16的连接是易断的。 Advantageously, the pin 20 and the connection 16 is supplied with frangible. 这样,缝钉18的一端可以与供给带16连接,另一端则是开放的。 Thus, the end of the staple 18 may be supplied with 16 and the other end is open. 另外,缝钉18可以带有3个或更多的脚20,或者做成任何其它合适的形状。 In addition, the staple 18 may have three or more feet 20, or made of any other suitable shape.

[0046] 供给带16和缝钉18可以以任何合适的形式制作在一起。 [0046] The supply belt 16 and staple 18 may be produced together in any suitable form. 例如,将一种扁平的,薄片材料用激光切割成长条,然后将每个长条用激光切割成指状,之后弯曲做成缝钉18的形状。 For example, a flat sheet material cutting laser strips, then cut each strip with a laser finger, made staple shape after bending 18. 用这种方法,缝钉18和供给带16形成一个整体结构。 In this way, the staple 18 and the feeding belt 16 to form a unitary structure. 但是,供给带16和缝钉18可以以任何合适的形式制作在一起。 However, the supply of strips 16 and 18 can be made staple together in any suitable form. 比如,缝钉18和供给带可以分别制作,之后缝钉18通过焊接,粘合或者其它方法以易断性的形式与供给带16连接。 For example, the staple 18 and supplied to the belt can be produced separately, after the staple 18 by welding, gluing or other methods to easily form and continuity of supply with 16 connections.

[0047] 供给带16可以以任何合适的易断性形式连接每一个对应的缝钉18。 [0047] supply 16 may be connected with any suitable forms of frangible corresponding to each staple 18. 比如,如图6详细所示,每一条供给带16都带有至少一个从其侧面突出的,或位于其中心向侧面延伸的标突28(Tab 28)。 For example, as shown in detail in FIG. 6, are each supplied with at least one strip 16 projecting from the side, or in the heart to the side where the subscript extending projection 28 (Tab 28). 或者,至少有一个位于不同方向的标突28。 Alternatively, at least one mark in different directions of projection 28. 有利的是,在生产过程中,对缝钉18的激光切割和后续的机械变形形成了标突28,从而使标突28和缝钉18与对应的供给带整合在一起。 Advantageously, in the production process, the staple 18 of the laser cutting and subsequent mechanical deformation of the standard projection 28 is formed so that the projections 28 and the staple mark 18 is supplied with a corresponding band together. 但是,标突28和/或缝钉18可以以任何合适的方式与供给带16制造在一起或相连接。 However, the standard projection 28 and / or staple 18 may be any suitable manner with 16 manufacturing and supply together or connected. 至少一个缝钉18以任何合适的方式与对应的标突28连接。 At least one staple 18 in any suitable manner with the corresponding standard projection 28 is connected. 缝钉18和对应的标突28间的连接方式可以是任何合适的方式。 Staple 18 and the corresponding standard projection 28 of the connection may be any suitable manner. 缝钉18和对应的标突28间的连接可以以任何合适的定位方向存在。 Standard projection 28 of the staple 18 and the corresponding connection can exist in any suitable positioning direction. 例如,至少一个标突28大致是长方形的。 For example, at least one mark projection 28 is substantially rectangular. 对应的缝钉18由该长方形标突28近侧边缘延伸出来。 18 corresponding staple of the rectangle marked by a sudden proximal edge 28 extends. 缝钉18可以从标突28分离出来,其分离位置大致位于缝钉18和标突28的连接部位。 Staple 18 may be projected from the standard 28 to separate, isolated location and is located approximately 18 standard staple protruding joints 28. 缝钉18和对应标突28间的连接足够牢固,能够在使用前使缝钉18固定在供给带16上,同时该连接也足够脆弱,使缝钉18在使用时或使用后能够从标突28上断裂或者分离开来。 Standard staple 18 and the corresponding projection 28 of the connection is firm enough before using staples 18 fixed on the supply belt 16, while the connection is also fragile enough that the staple 18 during use or after use can protruding from the standard broken or separated on 28. 或者,缝钉18和/或标突28在它们连接处或其附近带有一个被削弱的部位,使缝钉18和供给带16在使用时或使用之后容易分离。 Alternatively, the staple 18 and / or standard projection 28 easy to separate after they are connected at or near the site with a weakened, the staples 18 and supplied to the belt 16 when using or use. 被削弱的部分带有削弱的横截面,或者带有凹口,或者其它削弱的结构。 Weakened portion with weakened cross-section, or with a notch, or other weakening of the structure. 另外,被削弱的部分也可以是通过物理处理的或者设定成比周围材料薄弱,同时与周围的材料的物理大小基本相同。 Also, weakened portions may be processed by a physical or set weaker than the surrounding material, while the physical size substantially the same as the surrounding material.

[0048] 如图4-6所示为缝钉18部署前的初始结构。 [0048] As shown in Figure 4-6 as the initial structure of the staple 18 prior to deployment. 在初始结构中,缝钉18之间基本不接触。 In the initial configuration, substantially no contact between the staple 18. 或者,在初始结构中,至少两个缝钉18相互接触。 Alternatively, in the initial configuration, at least two staple 18 into contact with each other. 每一个缝钉18基本都位于同一个平面上。 Each staple 18 are located in substantially the same plane. 也就是说,缝钉18的形状为可使单个平面延伸贯穿整个缝钉18,并将其一分为二。 That is, the shape of the staple 18 enables a single plane extending throughout the staples 18, and one in two. 或者,至少一个缝钉18不是基本位于一单个平面上。 Or, at least one staple 18 is not substantially located on a single plane. 至少一个缝钉18是位于与供给带16大体垂直的平面上。 At least one staple 18 is located substantially perpendicular to the supply 16 with the plane. 或者,至少一个缝钉18是位于与供给带16成不同角度的平面上。 Or, at least one staple 18 is located on 16 different angles supplied with the plane. 一排或更多排26的缝钉18与供给带16连接。 One or more rows of staples 26, 18 and 16 are connected with the supply. 每排26的缝钉18位于相对于供给带16纵向中心线的基本相同的侧面位置。 Each row 26 of staples 18 located at substantially the same side with respect to the supply position 16 with the longitudinal centerline. 每排26的缝钉18基本都是纵向的。 Each row of staples 26 of 18 basically vertical. 如图6很好地显示三排26缝钉18可与供给带16连接:沿着供给带16每边各一排26,沿着供给带16中心一排26。 Figure 6 shows three rows of 26 well staples 18 may be supplied with 16 connections: supply along with 16 on each side of a row of 26, along with 16 supply centers in a row 26. 供给带16可以形成连续的环路或者具有相互分离的开端和末端。 16 may be supplied with a continuous loop or a beginning and an end separated from each other. 或者,可以有更多或更少排26的缝钉18与供给带16连接。 Alternatively, you can have more or less rows of staples 26, 18 and 16 are connected with the supply. 每排26可沿着供给带16局部或全部或长度方向延伸。 Each row of 26 may extend along part or all of the supply belt 16 or the longitudinal direction. 不同排26沿着供给带16延伸的长度可以不同。 26 different rows 16 extends along the length of the supply belt may be different.

[0049] 沿着单个供给带16的两排或更多不同排26的缝钉18可以以任何合适的方式排列。 Two or more rows of different rows of staples [0049] along with 16 of the 26 single supply 18 can be arranged in any suitable manner. 比如,沿着单个供给带16的两排或更多不同排26的缝钉18相互间可以错开排列。 Two rows or more rows of staples such as different, along with 16 of the 26 single supply of 18 may be staggered between each other. 也就是说,在沿着一单个供给带16某个纵向位置上,一排26的缝钉18与供给带16连接,在相同位置上至少有另外一排26的缝钉18与供给带16不连接。 That is, a single supply of strip 16 along a longitudinal position, a row of staples 26, 18 and 16 is connected with the supply, at the same position at least another row 26 of staples 18 and 16 is not supplied with connection. 这种缝钉18的错开排列有助于使用端部执行器4对组织止血。 Such staples staggered 18 facilitates the use of the end effector four pairs of tissue hemostasis. 如图6很好地显示,中间排26的缝钉18与沿着供给带16侧面边缘排列的缝钉排26的缝钉18错开排列。 Figure 6 shows a good, intermediate row of staples 18 and 26 along the side edges of the supply belt 16 arranged in rows of staples 26 of staple 18 staggered. 或者,两排或更多排26的缝钉18可以以不同的方式错开。 Alternatively, two or more rows of staples 26 of 18 may be shifted in different ways. 或者,沿着一单个供给带16的两排或更多排26的缝钉18可以在排26的至少部分长度上相互对齐。 Alternatively, a single feed strip 16 along two or more rows 26 of staples 18 may be aligned with each other in the upper row 26 of at least part of the length. 例如,在沿着供给带16的某个纵向位置上,一排26的缝钉18与供给带16连接,其它每排26同样有连接供给带16的缝钉。 For example, in a longitudinal position along the feed belt 16 on a row of staples 26, 18 and 16 are connected with the supply, every other row 26 also has a connection with the supply of staples 16. 或者,沿着一单个供给带16的两排或更多排26缝钉18在该供给带16的不同纵向部分上的排列不同。 Alternatively, two or more rows of staples 26 along a single feed belt 16 18 different longitudinal arrangement of 16 different parts in the supply belt. 缝钉18在内切割器2的不同供给带16上的相互之间的排列方式可以是相同或不同。 18, including the staple arrangement different from each other between the cutter 16 is supplied with 2 may be the same or different.

[0050] 每排26的缝钉18之间的间距基本相同。 [0050] The pitch of the staple 26 between each row 18 is substantially the same. 也就是说,任何两个纵向相邻的缝钉18的间距基本都相同。 That is, any two longitudinally adjacent staple 18 is substantially the same pitch. 或者,在每排26中至少有两个纵向相邻的缝钉18的间距与其它两个纵向相邻的缝钉18的间距不同。 Alternatively, each row 26 having at least two longitudinally spaced adjacent staple 18 and the other two longitudinally adjacent staple 18 of different pitches. 这种结构在缝钉线长度不可调的情况下是有用的。 In this configuration the staple line length in the case of non-adjustable useful. 由端部执行器4产生的缝钉线可以固定为某一特定数量的缝钉18,因此,每一排的缝钉18都可集合成一些组,每组具有与固定的缝钉线基本相同的长度。 4 by the end effector generated by the staple lines can be fixed to a specific number of staples 18, and therefore, each row of staples 18 can be grouped into several groups, each having a fixed substantially the same staple line length. 如果是这样,在排26中的每组缝钉18都可以与在供给带16上相邻的缝钉18组以一空白区分离。 If so, in row 26, each set of staple 18 can be supplied with 18 separate groups with a blank zone 16 adjacent staples. 其中,空白区的长度可以是任何合适的长度。 Wherein the length of the blank area may be any suitable length. 有利的是,没有缝钉18从供给带16的空白部分界定的区域延伸出来或延伸进去。 Advantageously, there is no regional staple blank 18 from the supply portion 16 with the definition of extending or extending into it.

[0051] 如图7所示,端部执行器4可以包括一个缝钉盒30和一个砧32。 [0051] As shown in Figure 7, the end 4 may comprise a staple cartridge 30 and an anvil 32. 砧32可以相对于缝钉盒30运动,从而压紧砧32和缝钉盒30之间的组织。 Anvil 32 with respect to the staple cartridge 30 movement, thereby pressing the anvil 32 and staple tissue between the cartridge 30. 砧32包括标准的缝钉弯曲部件使缝钉18容易闭合。 The anvil 32 includes a standard staple bending member 18 so that the staple easily closed. 或者,缝钉弯曲部件可以从砧32中去除。 Alternatively, the staple bending member may be removed from the anvil 32. 砧32相对于缝钉盒30可以转动。 The anvil 32 with respect to the staple cartridge 30 can be rotated. 例如,至少有一个栓34从砧32的近末端或附近基本沿着砧32侧向延伸出来。 For example, at least one bolt 34 extending substantially from the proximal end of the anvil 32 along or near the anvil 32 side. 每一个栓34都可以被槽36,隙缝或者其它缝钉盒30的部件容纳,栓34在该部件中可以转动,从而使砧32转动。 A bolt 34 can be accommodated each groove 36, slit or other staple cartridge member 30, the stopper member 34 may be rotated, so that the anvil 32 is rotated. 如图16所示,用这种方法,砧32在夹紧组织之前的第一初始状态下,其远末端可以和缝钉盒30分离,并置于其上,同时,砧32的近末端和缝钉盒30连接。 16, in this way, the anvil 32 in a first initial state prior to clamping tissue, its distal end and staple cartridge 30 can be separated, and placed on the same time, near the end of the anvil 32 and staple cartridge 30 is connected. 或者,槽36可以置于内切割器的杆轴6中,砧32与杆轴6可旋转式的连接,且相对于缝钉盒30是可运动的。 Alternatively, groove 36 may be placed within the cutter lever shaft 6, the anvil 32 and the lever shaft 6 rotatable connection, with respect to the staple cartridge 30 is movable. 或者,砧32可以以其它方式与缝钉盒连接且/或者相对于缝钉盒是可以运动的。 Alternatively, the anvil 32 may be otherwise connected with the staple cartridge and / or staple cartridge relative movement is possible. 或者,缝钉盒30相对于砧32是可以运动的。 Alternatively, the staple cartridge 30 relative to the anvil 32 is movement. 或者,缝钉盒30和砧32相对于彼此是可以运动的。 Alternatively, the staple cartridge 30 and anvil 32 relative to each other is movement. 缝钉盒30的远末端和砧32的远末端是钝的,这样可以防止端部执行器4在插入病人体内及到达治疗位置时,与组织无意的衔接。 The distal end of the staple cartridge 30 and the anvil 32 distal tip is blunt, which can prevent the end effector 4 inserted into the patient and arrive at the treatment site, and the organization has no intention of convergence. 有利的是,缝钉盒30被固定在端部执行器4的剩余部分上和/或杆轴6,而且是不可拆卸的。 Advantageously, the staple cartridge 30 is fixed to the remaining portion of the end effector 4 and / or the lever shaft 6, and is not removable. 如以下详细内容所述,缝钉盒30可以使用多次而不需要从病人体内取出,因此,在放出缝钉18后,我们不需要将端部执行器4从病人体内取出,来替换缝钉夹或是其它部件。 As described in detail below content, staple cartridge 30 can be used multiple times without the need to remove from the patient, therefore, after the release of the staple 18, we do not need to remove from the patient 4 end effector, to replace the staple clip or other components. 但是如果需要,缝钉盒30相对于端部执行器4的剩余部分和/或杆轴6是可拆卸的;端部执行器4相对于杆轴6是可拆卸的;和/或者杆轴6相对于手柄8是可拆卸的。 However, if desired, the staple cartridge 30 relative to the remainder of the end effector 4 and / or the lever shaft 6 is removable; end actuator relative to the lever shaft 4 is detachable 6; and / or the lever shaft 6 8 relative to the handle is detachable.

[0052] 缝钉盒30可包括任何合适的部件。 [0052] staple cartridge 30 may comprise any suitable components. 如图8-10所示,缝钉盒30可包括一个供给带引导器40。 Shown in Figure 8-10, staple cartridge 30 may include a supply belt guide 40. 该供给带引导器40可以是任何形状。 The supply belt guide 40 may be any shape. 缝钉盒30可被构造成使得供给带引导器40的远末端就是端部执行器4的远末端。 Staple cartridge 30 may be configured such that the distal end of the supply belt guide is the end effector 40 distal end 4. 如果这样,供给带引导器40的远末端42可以基本上是钝的。 If so, is supplied with a guide 40 of the distal tip 42 may be substantially blunt. 供给带引导器40的远末端42的上表面44带有基本向上的角度,沿着供给带引导器40向近处运动。 Supplied with the upper surface of the distal end of guide 40 42 44 with a substantially upward angle, 40 to near movement along the supply belt guide. 或者,供给带引导器40的远末端42的上表面44可以是任何其它合适的形状。 Alternatively, the supply with the upper surface of the distal end of the introducer 40 42 44 may be any other suitable shape. 供给带引导器40的远末端42的上表面44上可以设定一个或更多个隙缝46。 Supplied with a guide on the surface of the distal tip 40 of 42 can be set to one or more apertures 46, 44. 或者,可以去除一个或更多个隙缝46,使得供给带引导器40的远末端42的上表面44是连续的。 Alternatively, one may remove one or more apertures 46, so that the supply belt guide 40 of the upper surface 44 of the distal end 42 is continuous. 供给带引导器`40的远末端42可包括一设于其中的空间48,至少一个突出部50从远处突出进入该空间48。 Guide 40 'is supplied with the distal end 42 may include a space 48 provided therein, at least one protrusion 50 protruding from a distance into the space 48. 每一个突出部50都可以是弯曲的,且可以为凸形。 Each protrusion 50 may be curved, and may be convex. 例如,每一个突出部50可以为弓形,其中的弓形是圆的一部分。 For example, each protrusion 50 may be arcuate, wherein the arcuate portion of a circle. 或者,至少有一个突出部的形状是不同的。 Alternatively, at least one shaped protrusion is different. 例如,至少有一个突出部50的形状是由两个或更多个直线形成的粗糙的或平滑的弧线状。 For example, the shape of at least one projecting portion 50 is rough or smooth curved shape by two or more straight lines.

[0053] 如图12所示,端部执行器4可包括两个供给带16,这种设计在组织切口或横切部的两边都能使用缝钉18。 [0053] 12, the end 4 may comprise two feeding belt 16, in this design the cut cross section on both sides of tissue or staple 18 can be used. 或者,端部执行器4包括仅仅一个或三个或更多个供给带16。 Alternatively, the end portion of the actuator 4 includes only one or three or more supply belt 16. 供给带16之间可以相互独立,或者以任何形式连接。 Between the supply belt 16 can be independent to each other, or connected in any way. 供给带16可以布置在每一个突出部50的周围,突出部50在侧向上相互间隔,并位于刀的相对的面,该设计如下所述。 Feeding strip 16 may be arranged around each of the projecting portions 50, projecting portions 50 laterally spaced from each other, and a surface located opposite the knife, the design as described below. 每一个供给带16可沿着一轨迹布置,该轨迹开始时基本为直线且朝向远处,然后沿着对应的突出部50的表面弯曲,之后朝向近处且逐渐变直。 Each supply tape 16 may be arranged along a track at the start of the track is substantially straight line and face the distance, and then along the curved surface of the corresponding protrusion 50, and then gradually increases toward the near straight. 也就是说突出部50改变对应供给带16运行方向,使其从朝向大体远处方向转变到大体近处方向。 That 50 is supplied with a corresponding change in the protrusion 16 running direction to shift from a distance direction substantially toward the direction substantially Vicinity. 每一个突出部50的宽度和沿着该突出部表面运动的对应供给带16的宽度基本相同。 Width of each projecting portion 50 and the width of the projecting portion is supplied along the corresponding surface motion of the belt 16 is substantially the same. 或者,至少一个突出部50比对应的供给带16更窄或者更宽。 Alternatively, at least one projecting portion 50 than the corresponding supply 16 is narrower or wider tape. 或者,可以去除突出部50,这样供给带16基本沿直线运动。 Alternatively, protrusion 50 may be removed, so that 16 is supplied with a motion substantially along a straight line.

[0054] 至少一个突出部50被其中设定的狭槽52分开。 [0054] at least one projecting portion 50 is a slot 52 which is set separately. 狭槽52的方向基本是纵向的。 Direction of the slot 52 is substantially vertical. 但是,狭槽52也可以具有任何其它合适的方向。 However, the slot 52 may have any other suitable direction. 每一个供给带16与对应的突出部50至少部分接触,供给带16的每一最外侧的每一排26的缝钉18位于突出部50的每一边侧面。 Each belt 16 is supplied with the corresponding portions 50 projecting at least partly into contact with a supply of staples 16 of each row 26 of each outermost projection 18 is located on each side of the side portion 50. 如图6所示,当供给带16的中间带有一排26缝钉18时,突出部50的狭槽52可横向放置于与中间排26缝钉18基本相同的位置。 As shown in Figure 6, when supplied with the intermediate 16 with a row of staples 18:00 26, the projection 50 of the slot 52 may be placed horizontally in the middle of row 26 of staples 18 in substantially the same position. 这样,狭槽52就为中间排26缝钉18滑动提供了空间。 Thus, the slot 52 provides space for the middle row 26 of staples 18 to slide. 或者,至少一个突出部50被两个或更多个狭槽52分成几个部分,其可根据连接在对应供给带16上的缝钉18排26的排数决定。 Or, at least one protrusion 50 is two or more slots 52 is divided into several parts, which can be supplied with 16 staples on the number 18 in a row 26 in accordance with the decision in the corresponding connection. 或者,这个狭槽或更多狭槽52不必延伸至突出部50的远末端,因为当供给带16的对应部分到达突出部50时,该部分所带缝钉18已经被部署出去了,更详细的介绍请看以下内容。 Alternatively, the slot or more slots 52 need not extend to the distal end of the projecting portion 50, since when supplied with a corresponding portion 16 of the projecting portion 50 reaches the portion 18 has been brought staples deployed out more detail Introduction Consider the following. 或者,可以去除至少一个狭槽52。 Alternatively, at least one slot 52 is removed. 至少一个突出部50可在近处方向上延伸任何合适的长度。 At least one protrusion 50 may be any suitable length extending in the direction of the vicinity. 类似地,供给带导引器40的剩余部分可以在近处方向上延伸任何合适的长度。 Similarly, the remaining portion is supplied with a guide 40 may be any suitable length extending in the direction of the vicinity. 供给带引导器40接近远末端42的部分可以称为插入43。 40 is supplied with a guide 42 near the distal end of the insertion portion 43 can be referred to. 刀片槽54可以沿着供给带引导器40的长度方向延伸,并且可以贯穿供给带引导器40远末端42的上表面44。 Blade slot 54 can take along the feed guide 40 extending in the longitudinal direction, and can be used throughout the supply belt guide 40 away on the surface 42 of the 44 ends.

[0055] 如图11所示为外壳60。 [0055] 11 to the housing 60. 外壳60可以由单片片状金属制备。 The housing 60 can be prepared from a single piece of sheet metal. 或者,外壳60可以通过其它合适的方式和/或其它材料制备。 Alternatively, the housing 60 by other suitable means and / or other materials prepared. 外壳60包括一个基本平整的底座62,两个基本垂直底座62向上延伸的外壁64。 The housing 60 includes a substantially flat base 62, two substantially vertical outer wall 62 extending upwardly chassis 64. 底座62和外壁64基本为长方形。 The base 62 and the outer wall 64 is substantially rectangular. 外壁64之间基本互相平行。 Substantially parallel to each other between the outer wall 64. 或者,底座62和外壁64的形状,和/或设置方向各不相同。 Alternatively, the shape of the base 62 and the outer wall 64, and / or set different direction. 顶板66从每一个外壁64的上边缘基本侧伸出来,使得两个顶板66基本都在同一平面上。 Top 66 from each side of the upper edge of the outer wall 64 of the basic sticking out so that the two top 66 basically in the same plane. 每一个顶板66基本都是长方形。 Each top 66 are basically rectangular. 每一个顶板66都带有一些隙缝67。 Each comes with a number of top 66 slot 67. 这些隙缝67可以让缝钉18通过,进而部署出去。 These apertures 67 may allow staple 18 through, and then deploy out. 两个顶板66沿着他们长度方向相互分离。 Two top 66 separated from each other along their length. 内壁68从每一个顶板66的内边缘大体向下延伸,并且与对应的顶板基本垂直。 An inner wall 68 extending generally downwardly from the inner edge of each top plate 66, and substantially perpendicular to the corresponding top plate. 每一个内壁68基本都是长方形。 Each of the inner wall 68 basically rectangular. 内壁68相互分离且基本平行。 An inner wall 68 separated from each other and substantially parallel. 但是,至少有一个内壁68的形状和/或设置方向可以是不同的。 However, at least one inner wall shape and / or arrangement direction 68 may be different. 内壁68间分开的距离足够大,可以容纳刀片在其间通过,更详细描述请看以下内容。 Between the inner wall 68 separated by a distance large enough to hold the blade in the meantime by a more detailed description see below. 至少一个内壁68的下边缘与底座62接触`,或者也可以与底座62分离。 At least one lower edge of the base 62 in contact with the inner wall 68 ', or may be separated from the base 62. 接收空间70是由底座62,外壁64,顶板66和内壁68构成的外壳容积。 Receiving space 70 by the base 62, the outer wall 64, the top plate 66 and the inner wall of the housing 68. volume. 外壳60可以带有两个接收空间。 Housing 60 may be provided with two receiving spaces.

[0056] 至少部分外壳60可以去除顶板66和/或内壁68,使得至少部分外壳60的形状基本为U形。 [0056] at least a portion of the housing 60 the top plate 66 may be removed and / or the inner wall 68, such that at least part of the shape of the housing 60 is substantially U-shaped. 供给带引导器40可以和外壳60连接,该连接可以通过任何合适的方式完成。 Supplied with a guide 40 and the housing 60 may be connected, the connection may be by any suitable means. 例如,供给带引导器40的插入43可以插入一个或更多接收空间70中,然后以任何合适的方式固定。 For example, 40 is supplied with an insertion guide 43 may be interrupted by one or more receiving space 70, and then secured in any suitable manner. 又例如,供给带引导器40可以不包括插入43,供给带引导器以任何合适的方式与外壳60远末端连接。 As another example, the supply of the tape guide 40 may not include the insert 43, is supplied with a guide in any suitable manner connected to the distal end of the housing 60. 又例如,供给带引导器40可以和外壳60整体制作在一起。 As another example, the supply belt guide 40 and the housing 60 as a whole can make together. 或者,供给带引导器40既不连接外壳60也不固定在外壳60上。 Alternatively, the supply guide 40 is neither connected with the housing 60 is not fixed to the housing 60.

[0057] 如图13所示,一个或更多楔形部件延伸至端部执行器4的缝钉盒30。 , One or more wedge-shaped member extending [0057] As shown in FIG. 13 to the end effector staple cartridge 30 4. 每一个楔形部件72的臂76远末端都可以包括一个楔74。 Each wedge member 72 of the arm 76 distal tip 74 may include a wedge. 或者,楔74位于臂76的不同位置。 Alternatively, the wedge 74 is in a different position of the arm 76. 楔74可以具有任何合适的形状。 Wedge 74 may have any suitable shape. 例如,楔74的上表面包括一个带有角度或向上弯曲的第一表面79,并向远处方向延伸。 For example, the upper surface of the wedge 74 includes an upwardly angled or curved first surface 79, extending to a distance. 楔74也可以包括一个远离第一表面79的第二表面80,其中,第二表面可能带一定角度或者向下弯曲,并向远处方向延伸。 Wedge 74 may also include a second surface 80 remote from the first surface 79, wherein the second surface of the belt may be angled or bent downward, to a distance direction. 第一表面79和第二表面80间的相交部分是弯曲或平滑的顶端82。 Intersection of the first surface 79 and a second surface 80 is curved or smooth top 82. 或者,顶端82在第一表面79和第二表面80间形成一个不平滑的角度。 Alternatively, the top 82 in the first surface 79 and a second surface 80 to form an uneven angle. 楔74下表面基本上是直线形的。 Under the surface of the wedge 74 is substantially linear. 或者,楔74下表面是弯曲的,带有角度的,或者其它任何合适的形状。 Alternatively, the lower surface of wedge 74 is curved, or any other suitable shape with angles. 标突78可以位于臂76的任何位置。 Standard projection 78 may be located in any position of the arm 76. 标突78基本是长方形或者其它不同的形状。 Standard projection 78 is substantially rectangular or various other shapes. 标突78可以自臂76向下延伸,同时楔74可以自臂76向上延伸。 Standard projection 78 may extend downward from the arm 76, while the wedge 74 may extend upwardly from the arm 76. 或者,楔74和/或标突78相对于臂76的方向各不相同。 Alternatively, the wedge 74 and / or standard projection 78 relative to the direction of the arm 76 varies. 有利的是,楔部件72是以单个整体结构制作出来的。 Advantageously, the wedge member 72 is made out of a single unitary structure. 但是,楔部件72可以通过独立的部件以任何合适的方式组装获得。 However, the wedge member 72 can be separate components assembled in any suitable manner to obtain. 如图12所示,每一个楔74最初可处于远离缝钉18排26的位置,并且在基本纵向上与对应的缝钉18排26排成直线,相对于对应的缝钉18排26能够纵向运动。 12, each wedge 74 may initially be in row 18 of staples 26 remote from the location, and on the base with the corresponding longitudinal rows of staples 18 arranged in a straight line 26, with respect to the corresponding rows of staples 18 26 longitudinally movement. 每一个楔74的长度可以等于或小于缝钉18排26的纵向间距,使得楔74在移动接触后续排26的缝钉18前部署每一个缝钉18。 The length of each wedge 74 may be equal to or less than 18 rows of staples longitudinal spacing 26 so that the wedge 74 in a subsequent row of staples moving contact 26 of 18 prior to deployment of each staple 18. 这种楔74的构造在缝钉线长度可以调节时特别有用,因为一个缝钉18的部署与其它任何缝钉18的部署都是不相关的。 This configuration is particularly useful when the wedge 74 in the staple line length can be adjusted, as a staple deployment and any other 18 of the staple 18 is deployed irrelevant. 或者,楔74的长度大于排26的缝钉18的纵向间距,使得当一个缝钉18的部署完成时,纵向相邻的缝钉18正在部署过程中。 Alternatively, the length of the wedge 74 is greater than the row 26 of staples longitudinal spacing of 18, so that when a staple when the deployment is completed 18, longitudinally adjacent staple 18 being the deployment process. 这种楔74结构在缝钉线的长度固定,并且供给带16上沿排26的缝钉组间存在空白区时是有用的。 This wedge 74 structures in the staple line length is fixed, and is supplied along with 16 rows when blank areas between the staple set 26 is useful.

[0058] 如图14所示,楔部件72的标突78可以插入模块84的接收槽86内。 [0058] As shown, the wedge member 72 of the 78 standard projection 14 can be inserted into the module receiving slot 86 84. 每一个接收槽86可以部分深入或者完全贯穿模块84。 Each receiving groove 86 may be partially or completely through the depth module 84. 一个或多个接收槽86可以位于模块84的上表面88,或者其它表面上。 One or more receiving grooves 86 may be located on the surface 88 of the module 84, or other surface. 一个或多个接收槽86可以位于模块84的远末端或其附近,或在模块84的其它位置。 One or more receiving grooves 84 of the module 86 may be located at or near the distal end, or other locations in the module 84. 如图15所示,刀90近末端可带有一个弯钩92。 As shown in Figure 15, the knife 90 may be provided with a hook near the end 92. 栓94横向贯穿模块84近末端的刀片接收槽96,并且弯钩92可以与栓94衔接。 Bolt 94 transversely across module 84 near the end of the blade receiving slot 96, and the hook 92 and bolt 94 can join. 栓94可基本上是圆柱形的或者其它能够衔接弯钩的合适形状。 Bolt 94 may be substantially cylindrical or other suitable shapes can link hooks. 或者,刀片接受槽86位于模块84的其它部分。 Alternatively, the blade receiving slots 86 other parts of the module 84. 或者,刀90的弯钩92可以是类似楔部件72的标突78的标突,这样刀片接收槽86也需要设定成与楔部件72的标突78的接受槽86 —样的构造。 Alternatively, the knife 90, 92 may be similar to the standard hook wedge member 72 projecting 78 standard projection, so blade receiving slot 86 also needs to be set to the standard wedge member 72 projecting 78 receiving groove 86 - kind of structure. 或者,弯钩92可以是任何其它合适的形状,例如不是弯钩的形状,刀片接收槽96也作相应的设置。 Alternatively, the hook 92 may be any other suitable shape, such as not hook shape, blade receiving slot 96 is also set accordingly. 或者,可以去除接受槽86,刀片接受槽86和/或标突78。 Alternatively, you can remove receiver slot 86, the blade receiving slot 86 and / or 78 standard projections. 楔部件72和/或刀90以不同的方式连接模块84,例如通过浇铸。 The wedge member 72 and / or the blade 90 is connected to the module 84 in different ways, for example by casting. 或者,楔部件72,刀90和模块84可以以一个整体制作在一起。 Alternatively, the wedge member 72, the knife 90 and the module 84 can be a whole production together. 模块84基本上是长方形固体。 Module 84 is substantially rectangular solid. 或者,模块84是任何其它合适的形状。 Alternatively, the module 84 is in any other suitable shape. 突出98在模块84近末端或其附近自模块84的上表面88基本向上延伸。 98 extending substantially upwardly projecting module 84 near the end of the module on or near the surface 88 from 84. 或者,突出98可以向不同方向延伸和/或在模块84的不同位置上延伸出来。 Alternatively, highlight the 98 may extend in different directions and / or extend at a different location on the module 84. 突出98大体是长方形固体,但是可以是其它合适的形状。 A generally rectangular solid projecting 98, but may be other suitable shape. 或者,可以去除模块84,而楔部件72和刀90可以以其它合适的方式控制和/或操控。 Alternatively, you can remove the module 84, and the wedge member 72 and the blade 90 may be other suitable manner to control and / or manipulation.

[0059] 模块84至少部分可位于空间中,如端部执行器4和/或杆轴6的壁凹120中(图17A),模块84为了控制楔部件72和刀90的运动而能够沿着该空间纵向滑行。 [0059] module 84 may be located at least partially in the space, such as end effector 4 and / or the wall of the recess 6 lever shaft 120 (FIG. 17A), the module 84 in order to control movement of the wedge member 72 and the blade 90 and movable along The space longitudinal slide. 或者,模块84相对于端部执行器4和/或杆轴6的位置不同。 Alternatively, the module 84 position the end effector 4 and / or 6 with respect to the lever shaft are different. 或者,一个或更多滑行器100可从模块84下表面102向下延伸,以便与端部执行器和/或杆轴6对应的结构衔接,帮助模块84滑动。 Alternatively, one or more skid 100 may extend from the lower surface of the module 102 down 84 to the end effector and / or lever shaft 6 corresponding structural cohesion, help module 84 slide. 或者,可以去除滑行器100。 Alternatively, you can remove 100 glider. 如图16所示,杆104可以以任何方式与突出98连接。 As shown in Figure 16, the rod 104 may be connected in any way with the projection 98. 例如,杆104可以与突出98浇铸连接。 For example, the rod 104 connected to the protrusion 98 may be cast. 杆104的远末端可以连接突出98,杆104可以延伸穿过杆轴6,使得杆104的近末端延伸至手柄8。 Near the end of the distal end of the rod 104 can be connected to projection 98, the lever 104 may extend through the lever shaft 6, so that the rod 104 extends to the handle 8. 杆104可以基本是钢硬的,且基本纵向延伸至杆轴6和/或通过杆轴6至手柄8。 Steel rod 104 may be substantially rigid, and substantially longitudinally extending to the rod axis 6 and / or to the handle by means of the lever shaft 6 8. 或者,杆104是可弯曲的和/或带有螺纹的,且杆104可以和突出98或模块84的其它部件中的螺纹衔接。 Alternatively, the rod 104 is flexible and / or threaded and the rod 104 and the projection 98 may be other components or modules 84 threaded adapter. 这样,旋转杆104可以纵向推进或拉回模块84。 Thus, the rotating lever 104 can be advanced or retracted longitudinally module 84.

[0060] 如图15所示,刀90可包括自弯钩92延伸出来向远末端方向延伸的刀身106。 [0060] As shown in Figure 15, the knife 90 may include a hook 92 extending from the distal end of the blade 106 extending direction. 与楔部件72的臂76相似,刀90的刀身106在横向方向是薄的,且大于其宽度和高度。 And the wedge member 72 similar to arm 76, the knife 90 in the transverse direction of the blade 106 is thin, and is greater than its width and height. 或者,刀身106和/或至少一个臂76的形状不同。 Alternatively, blade 106, and / or at least one arm 76 of a different shape. 刀口108位于刀身106的远末端。 Located at the distal end of the blade edge 108 106. 有利的是,刀90可以制作成单个的整体结构。 Advantageously, the knife 90 can be made into a single unitary structure. 但是,刀90可以由独立的弯钩92,刀身106和/或刀口108组和而成。 However, the knife 90 can be made independent of the hook 92, the blade 106 and / or blade 108 group and together. 刀口108可以设置成任何可以切割组织的形式。 Blade 108 may be arranged in any form can cut tissue. 例如,刀口108包括沿着其上边缘的刀刃110,其中,刀刃110带有一个向上的角度,沿着刀口108近处延伸。 For example, blade 108 includes a cutting edge along its upper edge 110, wherein the blade 110 with an upward angle, extending along the edge 108 proximally. 或者,刀刃110设于刀口108上不同的方向和位置。 Alternatively, the blade 110 is provided in 108 different blade orientation and position. 如图11所不,刀90在顺着外壳60的内壁68间的至少部分空间内是可运动的。 Not shown in Figure 11, the knife 90 in the housing 60 along the inner wall of at least part of the space 68 is movable. 每一个供给带16的局部被置于每一个接收空间70中,从外壳60的内壁68横向伸出。 Each supply is placed with a local 16 each receiving space 70, 68 from the inner wall of the housing 60 extends laterally. 这样,刀90在两个供给带16间可以纵向运动。 Thus, the knife 90 is supplied with 16 in two longitudinally movement. [0059]或者,刀口108和/或刀90的刀刃110可为了烧灼组织而被加热。 [0059] Alternatively, the knife-edge 108 and / or knife blade 90 110 may be heated to cauterize tissue. 或者,可以使电流通过刀90的刀口108,使得使用刀口108电烧灼组织。 Or, you can make the current through the knife edge 90 of 108, makes use of electrocautery blade 108 organizations. 刀口108可以使单极的,或者是双极系统中的一极端。 Blade 108 can make unipolar or bipolar system an extreme. 或者,可以去除刀90,在其位置上使用电线。 Alternatively, you can remove the knife 90, the use of wires in its place. 电线可以从远处穿过缝钉盒30,自缝钉盒30向上至砧32,然后从近处穿出砧32。 Wire can pass through the staple cartridge 30 from a distance, from the staple cartridge 30 and anvil 32 up and out the near anvil 32. 电线的向近处的运动使电线穿过并切割组织。 Wires to a nearby sports make wires through and cut tissue. 电线可以是电极,因此可以通过使用电流帮助切割和电烧灼组织。 Wire may be an electrode, so you can help by cutting the use of current and electrical burning tissue. 电线在每次使用后取出,且更换新的电线,使端部执行器4能够夹紧另一个组织结构。 Remove the wire after each use, and the replacement of the wire, so that the ends of the actuator 4 can be clamped to another structure. 每次替换电线能够使切割器最大程度发挥切割和烧灼功能。 Each replacement wire cutter enables maximize cutting and burning capabilities.

[0061] 如图16所示为端部执行器4的一初始结构的横截面图。 [0061] As shown in FIG. 16 is a cross-sectional end view of a portion of the initial structure of the actuator 4. 刀90的刀口108在初始状态下可以完全置于缝钉盒30中,这样可以确保刀刃110在端部执行器4进入手术位置时不切割到组织。 90 knife blade 108 in the initial state can be entirely in the staple cartridge 30. This ensures that the blade 110 at the ends of the actuator 4 into the surgical site without cutting into the tissue. 另外,刀口108在初始状态下可以置于供给带引导器40远末端42内。 Further, blade 108 may be placed in the initial state is supplied with a guide 40 inside the distal tip 42. 或者,刀口108可以置于不同位置。 Alternatively, the edge 108 can be placed in different positions. 在初始状态下,缝钉18位于缝钉盒30中等待部署,每一个缝钉都位于顶板66的对应隙缝67下。 In the initial state, the staple 18 is located in the staple cartridge 30 to deploy waiting, each staple 66 are located in a corresponding slot 67 at the top plate. 模块84位于初始位置,对应刀口108和楔部件72的初始位置。 Module 84 is in the initial position, the initial position 108 and the corresponding edge 72 of the wedge member. 有利的是,在初始状态下,楔部件72和刀90都位于其最远的位置。 Advantageously, in the initial state, the wedge member 72 and the knife 90 is in its furthest position. 但是,至少一个楔部件72和/或刀90在初始状态下的位置可以是不同的。 However, at least one wedge member 72 and / or the blade 90 in a position in the initial state may be different.

[0062] 如图17所示,夹持器112可位于端部执行器4和杆轴6之间。 Shown in [0062] 17, the holder 112 may be positioned between the ends of the actuator 6 and the lever shaft 4. 或者,夹持器112可提供端部执行器4和杆轴6之间的连接,比如可通过摩擦力或干涉配合而使端部执行器4和杆轴6连接或者以其它方式使夹持器112与端部执行器4和杆轴6连接。 Alternatively, the holder 112 may be provided end 6 is connected between the actuator and the lever shaft 4, for example by friction or interference fit leaving the end effector 4 and the lever shaft 6 is connected, or otherwise make the holder 112 is connected with the end portion 4 and the actuator lever shaft 6. 或者,可以将夹持器112完全置于端部执行器4中。 Alternatively, the holder 112 entirely in the end effector 4. 夹持器112可以是任何合适的形状。 Holder 112 may be any suitable shape. 夹持器112包括自第一部分118远末端突出的延伸部分114,其中,延伸部分114远末端包括一个斜部116。 Holder 112 includes a first portion 118 from the distal end portion 114 protruding extension, wherein the extension portion 114 includes an angled distal end portion 116. 斜部116沿近处方向可以带有一个向上的角度。 Vicinity direction along the slant portion 116 may be provided with an upward angle. 斜部116可以基本为直线。 Inclined portions 116 may be substantially straight. 或者,斜部116带有不同的方向,可以是弯曲的或是某种形状。 Alternatively, the inclined portion 116 with different directions, may be curved or some shape. 第一部分118可以制作成适合被外壳60的近末端接收的形状和大小。 The first portion 118 can be made to fit to the shape and size of the proximal end of the housing 60 to receive. 而且,至少第一部分118的局部可以延伸至外壳60的至少一个接收空间70的近末端。 Moreover, at least a partial extension of the first portion 118 to the housing 60 may be at least one receiving space 70 of the proximal end. 第一部分118可以通过压力或者干涉配合,粘合,焊接或其它任何合适的途径和方法固定在外壳60上。 The first portion 118 may by pressure or interference fit, bonding, welding or any other suitable ways and means secured to the housing 60. 或者,夹持器112可以不固定在外壳60上或者不与外壳60连接。 Alternatively, the holder 112 may not be fixed to the housing 60 or 60 is not connected to the housing. 或者,可以去除夹持器112。 Alternatively, you can remove the holder 112. 或者,至少供给带引导器40局部也和夹持器112连接。 Or, at least partial supply belt guide 40 and the holder 112 is also connected. 例如,供给带引导器40的插入43可以完全贯穿外壳60的接收空间70,并和夹持器112接触。 For example, the supply belt guide 40 is inserted into the receiving space 43 may extend completely through the housing 60 70, and the contact 112 and the holder. 如果这样,供给带引导器40可以通过任何合适的形式与夹持器连接。 If so, is supplied with a guide 40 may be connected by any suitable form with the holder.

[0063] 如图17A所示,夹持器112底面带有一个壁凹120。 [0063] As shown in Figure 17A, the bottom surface of the holder 112 with a concave wall 120. 该壁凹120的形状和大小可以使模块84在其间滑动。 It said recess 120. The shape and size allows the module 84 to slide in the meantime. 壁凹120带有一个贯穿的狭槽122,其中,狭槽122可以接收突出98,使突出98可以在狭槽122内滑动。 Wall recess 120 with a slot 122 through which the slots 122 may receive prominent 98, the projecting 98 can slide within the slot 122. 壁凹120和/或狭槽122可以纵向引导模块84的运动,限制模块84在某位置远近移动,且能够限制模块84的横向移动。 Bay 120 and / or slots 122 can block movement of the longitudinal guide 84, the module 84 limits the distance moved in a certain position and to limit lateral movement of the module 84. 例如,壁凹120包括一远端壁124,其可在模块84向远处推进足够远时与模块84远末端接触,和一近端壁126,其可在模块84向内拉回足够近时与模块84近末端接触。 For example, the concave wall 120 includes a distal wall 124 of the module 84 can advance far enough away to a distant end when contact with the module 84, and a proximal end wall 126, which may be inwardly back in module 84 close enough Near the end of the contact with the module 84. 或者,可以在夹持器112的不同部分设置或去除壁凹120。 Alternatively, you can set up or removed in different parts of the wall of the recess 120 of the holder 112.

[0064] 如图30所示,我们可以选择滑动夹具160,其中,每一组滑动夹具160都与对应的供给带16相联系。 [0064] As shown in Figure 30, we can choose the slide clamp 160, wherein each set corresponding sliding fixture 160 are supplied with 16 linked. 每一组滑动夹具160可包括一上夹具162和一下夹具164,其中,夹具162和164至少有一个相对于另一个是可以滑动的。 Each group of the slide clamp 160 may include an upper jig and a lower jig 162 164, which clamps 162 and 164 have at least one relative to the other is slidable. 下夹具164在大体纵向上带有一个狭槽166且处于一个基本向上的方向。 Lower clamp 164 with a substantially longitudinal slots 166 and is in a substantially upward direction. 上夹具162带有一个大体向下的舌状物168,其中,舌状物168的大小和构造设定成能够放置于下夹具164的狭槽166。 The fixture 162 with a generally downward tongue 168, which is sized and configured tongue 168 is set so as to be placed on the lower jig 164 slot 166. 舌状物168可以比上夹具162的剩余部分更加狭窄,或者也可以是任何合适的大小。 Tongue 168 can be compared to the remaining portion of the upper jig 162 is more narrow, or may be any suitable size. 延伸出舌状物168的上夹具162的较宽部分在其下表面形成一架突169。 Wider portion extending tongue 168 on the jig 162 is formed in the lower surface of an abrupt 169. 上夹具162的上表面可以和供给带16具有基本相同的宽度。 On the surface of the upper jig 162 can be supplied to the belt 16 has substantially the same width.

[0065] 如图31所示,上夹具162上的远末端最初可以向远处方向延伸而超出下夹具164的远末端。 [0065] As shown in Figure 31, the distal end of the upper jig 162 on the jig may be initially distal end 164 extends distally beyond the lower direction. 或者,下夹具164的远末端最初可以向远末端延伸而超出上夹具162的远末端。 Alternatively, the distal end of the lower jig 164 may initially be beyond the distal end of the fixture 162 extends toward the far end. 或者,每一个上夹具162,下夹具164的远末端最初向远末端延伸的长度基本相同。 Alternatively, each of the upper jig 162, the length of the distal end of the lower jig 164 to the distal end of the first extension is substantially the same. 下夹具164的上表面可带有一个凸轮表面170。 The upper surface of the lower jig 164 can be provided with a cam surface 170. 类似的,上夹具162的架突169的形状可以用于确定凸轮表面172。 Similarly, the upper jig 162 protruding frame 169 may be used to determine the shape of the cam surface 172. 两个表面170和172相互衔接,使得在两个夹具162,164的初始位置时,上夹具162的高度比对应的供给带16上部高度低。 Two surfaces 170 and 172 interrelated, so that in the initial position the two clamps 162, 164, 162 more than the height of the fixture is supplied with a corresponding 16 upper level low. 这样供给带在推进的时候不会受到上夹具162的阻碍。 Thus, when supplied with advancing the jig 162 will not be hindered. 如图32-33所示,凸轮表面170,172可制成某形状,这样当上夹具162向近处收回和/或下夹具164向远处推进时,上夹具162被往上推而与供给带16接触。 As shown in Figure 32-33, the cam surface 170, 172 can be made of a shape, so that when the fixture 162 back proximally and / or the lower jig 164 advance to the distance, the jig 162 is pushed up with the supply with 16 contacts. 这种接触可以在部署缝钉18的过程中为供给带16提供额外的支撑。 Such contact may provide additional support for the supply belt 16 in the process of deploying the staple 18. 内切割器-两排缝钉 Endocutter - two rows of staples

[0066] 如图6所示,以上所述的内切割器2包括一个配置有两组或多组带有三排26缝钉18的端部执行器4。 [0066] As shown in Figure 6, the cutter 2 comprises the above-described configuration has an end portion having two or more sets of three rows of the actuator 26 of the staple 18 4. 但是,端部执行器4可以通过例如改变一条或更多供给带16上的缝钉18排26的数量来配置两组或更多组带不同数量的排26缝钉18。 However, the end of the actuator 4 for example, by changing one or more staples supplied with 16 18 26 Number of rows to be configured with two or more rows of staples 26 groups with different number of 18. 该端部执行器4基本可以根据上述内容设置。 The end of the actuator 4 which can be set according to the above. 例如,如图18-20所示,供给带16包括两排26缝钉18。 For example, as shown in FIG. 18-20, the supply belt 16 comprises two rows 26 of staples 18. 沿着该供给带16的每边都可以设置一排26缝钉18。 Along each side of the supply belt 16 can be set in a row 26 of staples 18. 结果,这样的供给带16比中心部分延伸有第三排26缝钉18的供给带16狭窄。 As a result, such a supply belt 16 extends over a central portion 26 with a supply of staples 18 in the third row with 16 narrow. 这样,端部执行器4可以通过减少缝钉18排26的数量来减小尺寸。 Thus, the end effector 4 staple 18 by reducing the number of rows 26 to reduce the size. 例如,以上所述`的带有三排26缝钉18的端部执行器的大小可制作能够穿过带有直径为IOmm的通道的套针孔10。 For example, the above described 'with three rows of staples 26 end of the size of the actuator 18 can be made to pass through the pinhole with a diameter of IOmm sleeve channel 10. 带有两排26缝钉18的端部执行器4的大小可制作成能够穿过带有直径为5mm的通道的套针孔10。 With two rows of 26 staple end effector 18 size 4 can be made to be able to pass through the pinhole with a diameter of 5mm sets of channel 10. 如图18-20所示,缝钉18的形状和位置可以根据供给带16而定,大体如上述带有三排26缝钉18的供给带16所示。 18-20, the shape and position of staples 18 can be supplied with a 16, substantially as shown in the above-mentioned supply 18 with three rows of 26 with 16 staples. 或者,缝钉18可以是相对供给带16任何合适的形状和/或位置。 Alternatively, the staple 18 may be relative supply belt 16 of any suitable shape and / or position. 缝钉18和供给带16可以是如上所述的易断性连接。 Easy staple 18 and 16 may be as described above is supplied with a broken connection. 或者,缝钉18可以以任何合适的形式与供给带16连接。 Alternatively, the staple 18 may be any suitable form and supply with 16 connections.

[0067] 至少两个在不同排26的缝钉18是相互错开的。 [0067] In at least two different rows 26 of staples 18 are staggered. 也就是说,沿着供给带16的某一个纵向位置上,一排26的缝钉18与供给带连接,另外一排26的缝钉18不和供给带16连接。 That, along with a supply of 16 on a longitudinal position, a row of staples 26, 18 and supplied with connection, another row of staples 26 and 18 is not supplied with 16 connections. 这种缝钉18的错开能更好的对端部执行器4处理后的组织进行止血。 Such staples staggered 4 treatment can organize better end of the actuator to be 18 to stop bleeding. 或者,每一排26的缝钉18都相互对齐。 Alternatively, each row 26 of staples 18 are aligned with each other. 也就是说沿着供给带16的某一个纵向位置上,一排26的缝钉18与供给带连接,则其它每排26的缝钉18都和供给带16连接。 That along with a supply of 16 on a longitudinal position, a row of staples 26, 18 en the supply, then every other row of staples 26 and 18 are supplied with 16 connections.

[0068] 每排26的缝钉18可以基本均匀间隔。 [0068] Each row of staples 26, 18 may be substantially uniform spacing. 也就是说,任何两个纵向相邻的缝钉18的间距基本相同。 That is, any two longitudinally adjacent staple 18 is substantially the same pitch. 或者,在所有排26中至少有两个纵向相邻的缝钉18的间隔与其它两个纵向相邻的缝钉18的间隔不同。 Alternatively, all rows 26 in at least two longitudinally spaced adjacent staple 18 and the other two longitudinally adjacent staple 18 in different intervals. 这样的构造在缝钉线长度不能调节的情况下是有用的。 Such a configuration in the case of the staple line length can not be adjusted is useful. 为端部执行器4制作的缝钉18的缝钉数可以设定在某一确定的数值,且每排缝钉18都集合成一些组,每组的长度与设定的缝钉线长度基本相同。 4 is an end portion of the actuator made staple staple 18 may be set at a number of the determined values, and each row of staples 18 are grouped into a number of groups, each group of the set length of staple length substantially the same. 因此,排26中的每组缝钉18可以由空白区域在供给带16上与相邻的缝钉18组分离。 Therefore, in each row 26 of staples 18 may be supplied by a blank area in 18 groups separated from the adjacent staple belt 16. 其中,空白区的长度可以是任何合适的长度。 Wherein the length of the blank area may be any suitable length.

[0069] 如图21所示,使用带有两排26缝钉18供给带16的端部执行器4和使用如图16所示的带有三排26缝钉18供给带16的端部执行器4的构造相似。 [0069] 21, with the use of two rows 26 of staples 18 is supplied with the end portion 16 of the actuator 16 shown in FIG. 4, and used with three rows 26 of staples 18 is supplied with the end effector 16 4 is similar in construction. 如图22所示,外壳60的构造和图11所示的外壳相似。 As shown, the housing 60 of the housing structure shown in FIG. 11 and 22 is similar to FIG. 外壳60的每个顶板66上都带有两排隙缝67,并与供给带16的两排26缝钉18对应。 18 corresponds to two rows of staples 26 on each top 66 of the housing 60 comes with two rows of slot 67, and the supply belt 16. 由于顶板66上有两排而不是三排隙缝67,顶板66及外壳60总体上比图16所示的外壳狭窄。 Because there are two rows of three rows of slits instead of 66 on the top plate 67, the top plate 66 and the housing shell 60 generally narrower than shown in Figure 16. 或者,至少部分外壳60去除顶板66和/或内壁68。 Or, at least part of the housing 60 to remove the top plate 66 and / or the inner wall 68. 如图23和24所示,为了适应更加狭窄的端部执行器4的内部空间,模块84的构造可以任选的和图14所示的模块84不同。 Module 84 shown in FIG. 23 and 24, in order to adapt to the narrower end of the inner space of the actuator 4, the module 84 can be optionally configured and 14 are different. 突出98可以在纵向上比图14所示的模块84的突出98更长。 98 can be shown protruding in the longitudinal direction of the module than 14 outstanding 84 98 longer. 杆104的远末端或其它部分可以以任何形式与突出98连接。 Distal tip or other parts of rod 104 may be connected in any way with the projection 98. 例如,杆104可以和突出98浇铸在一起。 For example, the lever 104 and the projection 98 can be cast together. 撑板130可自模块84上表面88向上延伸,其中,刀片接收槽96基本纵向设置于撑板130上。 Support plate 130 may extend upwardly from the module 84 on the surface 88, which substantially longitudinal blade receiving slot 96 disposed on the support plate 130. 撑板130可大致为三角形,或者其它任何合适的形状。 Support plate 130 may be substantially triangular, or any other suitable shape. 或者,撑板130可以与和杆104衔接的突出98相连接或成为其一部分。 Alternatively, the support plate 130 can be connected to or become part of the rod 104 and the convergence of prominent 98. 栓94可以横向延伸贯穿撑板130的刀片接收槽96,并和刀90近末端的弯钩92衔接。 Bolt 94 may extend transversely through the blade support plate 130 receiving slot 96, and 90 and knife near the end of the hook 92 converge. 或者,可以去除模块84。 Alternatively, you can remove the module 84.

[0070] 模块84可以带有两个部分深入或完全贯穿的接收槽86,其基本如图14所示。 [0070] module 84 may have a depth of two parts or completely through the receiving slot 86, the basic 14. 如图23A所示为楔部件72的另一个实例。 Another example is the wedge member 72 shown in FIG. 23A. 楔部件72如图14所示包括一个标突78和臂76。 The wedge member 72 shown in FIG. 14 comprises a projection 78 and the arm 76 standard. 但是,图23A所示的楔部件72远末端带有两个或多个楔74,其中楔74横向相互分隔,且基本相互平行。 However, the wedge member shown in FIG. 23A 72 with a distal end of two or more wedges 74, wherein the wedge 74 laterally spaced from each other, and substantially parallel to each other. 这样,单个臂76可以控制多条楔74,减少端部执行器4的部件数量,使端部执行器4能够做得更加狭窄。 Thus, a single arm 76 may control a plurality of wedge 74, to reduce the number of end effector member 4, so that the end portion of the actuator 4 can be made narrower. 楔74的形状可以如图14所示,或者可以是其它任何合适的形状。 Shaped wedge 74 may 14, or may be any other suitable shape. 图23A所示的每个楔部件72的标突78都可以插入图23所示的模块84的对应的接收槽86内。 Each wedge member shown in FIG. 23A standard projection 72 of 78 are shown in Fig. 23 corresponding insert receiving slot 86 in the module 84. 或者,图23所示的模块84可以带有四个接收槽86,并且使用图14所示的楔部件72。 Alternatively, the module 84 shown in FIG. 23 may be provided with four receiving slots 86, and the use of the wedge member 14 shown in FIG. 72. 或者,模块84可以设计成如上所述的如图14所示的结构。 Alternatively, the module 84 may be designed to structure 14 as described above, as shown in Fig.

[0071] 端部执行器4的两个实施例已经在上述内容中描述过。 [0071] two ends of the actuator of Example 4 has been described in the foregoing. 每个端部执行器都带有两排26缝钉18。 Each end of the actuator 26 comes with two rows of staples 18. 但是,`端部执行器4也可以设计成带有一组,三组或更多组缝钉18排26。 However, the `end effector 4 may be designed with a set of three or more sets of row 26 of staples 18. 另夕卜,供给带16可以设计成在一组排26中包括任何数量的排26缝钉18。 Another evening Bu, feeding belt 16 may be designed to include a set of row 26 in any number of row 26 of staples 18. 另外,刀90每边可以带有任何数量的供给带16。 In addition, the knife 90 on each side may have any number of supply with 16. 刀90 —边供给带16的数量可以和刀90另一边的数量相同或不同。 Knife 90-- supply side with the number 16 and the knife 90 can be the same or different on the other side of the number. 使用的供给带16的数量与端部执行器4处理的组织类型相关。 The number of end effector 16 is supplied for use with the four process-related tissue types. 每一条供给带16上的排26缝钉18的数量可以不同或相同。 Number of row 26 of staples 18 is supplied with 16 each may be different or the same. 每条供给带16上缝钉18排26的数量可以沿着供给带16的长度方向各不相同或者相同。 On each supplied with 16 rows of staples 18 the number 26 can be supplied along with the longitudinal direction 16 of the same or different. 在另一端部执行器4的实施例中,刀90被除去。 At the other end portion of the actuator of the fourth embodiment, the knife 90 is removed. 该端部执行器4只是一个简单的缝合器而不能切割组织。 The end effector 4 is a simple stapler can not cut tissue. 如果这样,我们可以使用任何合适数量的供给带16。 If so, we can use any suitable number of supply with 16.

[0072] 如图25-27所示为带有两排26缝钉18的供给带16的另一实施例。 [0072] As shown in Figure 25-27 is supplied with two rows of staples 18 26 16 with another embodiment. 该供给带16带有多个在其上或穿过其中的孔132。 The supply belt 16 with a plurality of apertures therein on or through 132. 孔132可以是圆形或其它任何合适的形状。 Hole 132 may be circular or any other suitable shape. 孔的大小和/或形状可以基本相同和/或不同。 Pore size and / or shape may be substantially the same and / or different. 孔132可以减少供给带16的阻滞性,使供给带16更加灵活,更容易顺着缝钉盒30的突出部50滑动。 Hole 132 may reduce supply of tape block 16, so that the supply belt 16 is more flexible, easier to slide along the staple cartridge 50 of the protrusion 30. 另外,内切割器2手柄8的栓或齿轮(未显示)可以和一个或更多孔132衔接,使供给带16运动。 Further, the inner cutter bolt or gear 2 handle 8 (not shown) may be one or more holes 132 convergence, supplied with 16 sports. 除孔132以外或用于替代孔132,供给带16侧面边缘可以带有一个或更多凹口134。 In addition to the hole 132 or holes 132 for an alternative, the side edge of the belt 16 can be supplied with one or more recesses 134. 每一个凹口134都与标突28相邻,或者一个或更多凹口134的位置不同。 Each recess 134 are marked with the adjacent projections 28, or one or more recesses 134 of different positions. 凹口134也有增加供给带16灵活性的作用,和/或增强手柄8的装置与供给带的衔接。 Notches 134 also has the flexibility to increase supply with 16 effects, and / or enhanced convergence means and supplied with handle 8.

[0073] 至少一个缝钉18的形状是连续的弧形,如图26所清楚显示。 [0073] at least one staple 18 is shaped continuous arcuate, as shown in Figure 26 clearly shown. 缝钉18远末端可以通过如上所述的例如供给带16侧面突出的标突28和供给带16连接。 Staple 18 through the distal tip 16 described above, for example the supply side with protruding projections 28 and supplied with a standard 16 connection. 缝钉18可以自标突28向下向近处延伸。 Staple 18 may be standard projection 28 extends downwardly from the vicinity. 之后,缝钉18继续向下弯曲,同时向远末端弯曲,形成一个隆起136。 After continuing to bend the staple 18 downwards, while bending to the far end, forming a ridge 136. 该隆起136可以向标突28的纵向位置延伸,超过标突28的远处纵向位置或者不及标突28的纵向位置。 The ridges 136 may be projected to the standard longitudinal position 28 extends over standard projection distance longitudinal position 28 or less marked the sudden longitudinal position 28. 然后,缝钉18可以继续向下弯曲同时向近处弯曲。 Then, the staple 18 may continue while bending bending down to near. 缝钉18继续向近轴方向弯曲,之后在转调点138开始向上弯曲。 18 continues to close the staple bending axis direction, after the redeployment of point 138 starts to bend upward. 然后,缝钉18继续向上向近处弯曲直至到达最后的在近末端的自由端22。 Then, the staple 18 to continue upward until it reaches the final bend near the proximal end of the free end 22.

[0074] 如图28所示,楔部件72的楔74的形状有助于图25_27所示缝钉的部署。 [0074] shown in Figure 28, the wedge shape of the wedge member 72 shown 25_27 74 contribute to deploy staples in FIG. 楔74包括第一段140和第二段142,第一段的形状有助于缝钉18的部署,第二段的形状有助于将缝钉18从供给带16上剪下或分离。 Wedge 74 includes a first section 140 and second section 142, the first paragraph of shape helps seam deploy staples 18, the second stage will help shape staple 18 from the feed belt 16 cut or separated. 第一段140向上及远处延伸,该弯曲可以是任何有助于缝钉18形成的形状。 The first section 140 extends upward and distant, the curved shape can be any help to the formation of the staple 18. 通过楔74上两个不同的段140和142,我们可以分别控制缝钉18的形成和分离。 By the wedge 74 in two different sections 140 and 142, we can control the formation and separation of staples 18. 操作 Operating

[0075] 如图2-3所示,至少一个套针孔10被插入病人14组织12的切口。 As shown in [0075] Figure 2-3, at least one set of pinhole 10 is inserted into the patient 14 tissue incision 12. 其中,套针孔10包括一切割装置(未显示),如尖状物,用于切开组织12,然后套针孔12被安装在组织上。 Which sets the pinhole 10 comprises a cutting device (not shown), such as spikes, 12 to cut the tissue, and then sets the pinhole 12 is mounted in the organization. 切割装置在套针孔10放置在组织12上后可被移出套针孔10。 Cutting device 10 is placed in the sleeve after the pinhole 12 can be removed tissue pinhole 10 sets. 或者,我们可以使用独立的装置先切开组织12,之后再将套针孔10置于切口处。 Or, we can use a separate device to cut the tissue 12, then after 10 sets of pinhole placed incision. 拥有相同或不同截面形状和/或面积的多个套针孔10可以置于病人14上体内。 Have the same or different cross-sectional shape and / or area of more than 10 sets of pinhole 14 can be placed on the body of the patient. 组织12可以是病人14的胸壁,由此可以进入胸腔。 12 patients with chest wall tissue 14 may be, whereby into the chest. 但是,组织12也可以是病人14的腹壁或者其它合适的组织。 However, the tissue or abdominal wall 12 may be of other suitable tissue of a patient 14. 或者,我们可以不使用一个或多个套针孔10,而通过其它途径到达手术位置,如以上所述方法。 Alternatively, we may not use one or more sets of pin holes 10, and reaches the surgical site through other means, the method as described above.

[0076] 如图1,16和21所示,内切割器2的端部执行器4通过一个套针孔10进入病人14体内。 [0076] in FIG. 1, 16 and 21, the inner ends of the cutter actuator 2, 4 through a pin hole 10 into the patient 14 sets of body. 内切割器2的杆轴6的至少局部随着端部执行器4进入病人14体内。 The cutter lever shaft 2 at least partially as the end effector 14 4 into the patient's body 6. 或者,我们不使用一个或多个套针孔10,而在常规的开窗手术步骤中使用内部切割器2,或者直接通过组织12上的切口进入病人14体内。 Or, we do not use one or more sets of pinhole 10, while using the internal cutter in a conventional fenestration step 2, or directly into the patient's body through tissue incision 14 on 12. 使用者将端部执行器4置于手术位置,例如,如图29所示,手术位置位于需要横切的血管148。 The end user will be placed in operative position 4, e.g., as shown, surgical located transverse vessel 148 needs 29. 需要澄清的是,本申请虽然描述了内切割器2横切血管148的手术,但是,内切割器的使用绝不仅限于横切血管。 The need to clarify that, although the present application describes endocutter 2 148 cross-vascular surgery, but, within the cutter must not be limited to use cross blood vessels. 其可以用于身体任何位置上的任何其它合适的手术程序。 It can be used for any other suitable surgical procedure at any location on the body. 例如,内切割器2可以用于横切胆管,切除病变的阑尾,或用于横切肠胃组织,和/或横切软组织或器官。 For example, within the cutter 2 can be used for cross-duct, removal of diseased appendix, or to cross the stomach tissue and / or crosscutting soft tissue or organ.

[0077] 如图16和21所示,在初始状态中,至少砧32的远末端是和缝钉盒30隔开的。 [0077] FIG. 16 and 21, in the initial state, at least 32 of the distal end of the anvil and staple cartridge 30 is separated. 这样可以使端部执行器4张开。 This allows the end effector 4 open. 端部执行器4在需要横切的血管148上推进直至血管148的整个直径长度都位于砧32和缝钉盒30之间。 Advancing the end effector 4 in the required transverse diameter of the blood vessel 148 until the entire length of the vessel 148 are positioned between the anvil 32 and staple cartridge 30. 有利的是,血管148的角度基本垂直于砧32和缝钉盒30。 Advantageously, the vessel 148 is substantially perpendicular to the angle of the anvil 32 and staple cartridge 30. 但是,血管148相对于砧32和缝钉盒30的角度可以是任何合适的角度。 However, with respect to the vessel 148 and the angle of the anvil 32 staple cartridge 30 may be any suitable angle. 我们通过将砧32向缝钉盒30移动来关闭端部执行器4,这样就可以将血管148夹紧在砧32和缝钉盒30间。 We will anvil 32 to the staple cartridge 30 is moved to close the ends of the actuator 4, so you can be 148 vascular clamping anvil 32 and staple cartridge 30. 闭合端部执行器4可以通过任何标准的或合适的方式完成。 Closed-end actuator 4 can be accomplished by any standard or suitable manner. 例如,可以使用软管在砧32和缝钉盒30的外表面上向远处推进,将砧32和缝钉盒30夹紧在一起。 For example, you can use a hose advance to the distance to the outer surface of the anvil 32 and staple cartridge 30, the anvil 32 and staple cartridge 30 are clamped together. 或者,砧32可以相对于端部执行器4的剩余部分和/或杆轴6是基本固定的,缝钉盒30可以向砧32移动,使端部执行器4闭合。 Alternatively, the anvil 32 with respect to the remaining portion of the end portion of the actuator 4 and / or the lever shaft 6 is substantially fixed, staple cartridge 30 can be moved to the anvil 32, so that the end portion of the actuator 4 is closed. 或者,砧32和缝钉盒30为了闭合端部执行器相互都是可以移动的。 Alternatively, the anvil 32 and staple cartridge 30 in order to close the end effector are mutually movable. 端部执行器4的闭合可以通过开动内切割器2手柄8上的一个或更多个控制器和/或释放储存在手柄8内的能量完成。 Energy closed-end actuator 4 may be stored in the handle 8 by 8 in the start of a cutter on the handle 2 or more controllers and / or release is completed. 在端部执行器4闭合后,端部执行器4便稳定且牢固地控制了需要处理的组织。 After the end of the actuator 4 is closed, the end effector 4 will be stable and firm control of the organization need to be addressed.

[0078] 如图6和12所示为楔74的初始状态。 As shown in [0078] FIG. 6 and 12 to 74 of the initial state of the wedge. 其中每条楔74都远离对应排26中的缝钉18。 Wherein each wedge 74 are away from the corresponding row of staples 26 18. 另外,如图11所不,每排26中至少一个缝钉18最初是位于外壳60顶板66的对应隙缝67下。 Further, as shown in Figure 11 does not, at least one of each row 26 of staples 18 is initially located in the housing 60 corresponding to the slit 67 of the top plate 66 at. 有利的是,一个缝钉18最初是位于外壳60顶板66的每一对应隙缝67下。 Advantageously, a staple 18 is initially located in the housing 60 of the top plate 66 of each slit 67 corresponding to the next. 如图14和17A所示,模块84最初位于或邻近壁凹120的远端壁124。 As shown in Fig. 14 and 17A, the module 84 is initially located adjacent bays or distal wall 120 of 124. 或者,模块84最初位于或邻近壁凹120的近末端,或者位于相对壁凹120的不同位置。 Alternatively, the module 84 is initially located adjacent bays or near the end of the 120, or located on the opposite wall of the recess 120 different locations. 在使用如图23所示的模块84的缝钉盒30中,模块84可以是处于缝钉盒30和/或内切割器2的杆轴6内初始位置,其中,模块84位于或临近缝钉盒30和/或杆轴6内部壁凹或空间远末端。 As shown in Figure 23 using the staple cartridge 30 of the module 84, the module 84 may be in staple cartridge 30 and / or the inner shaft 2 of the cutter lever 6 an initial position, wherein the module 84 at or near the staple box 30 and / or lever shaft 6 inside the far end of the bay or space. 或者,模块84位于或临近缝钉盒30和/或杆轴6内部壁凹或空间近末端,或在缝钉盒30和/或杆轴6的不同位置。 Alternatively, the module 84 is located at or near the staple cartridge 30 and / or lever shaft 6 internal bays or space near the end, or staple cartridge in 30 different locations and / or rod shaft 6. 如图15,16和21所示,刀90位于相对于缝钉盒30的一初始位置,其中刀90的刀刃110可以完全容纳在缝钉盒30内。 FIG. 15, 16 and 21, the knife 90 is located with respect to staple cartridge 30 in an initial position, wherein the knife blade 90 can be completely housed within the 110 staple cartridge 30. 也可以是至少部分刀口108容纳在缝钉盒30中,如图8所示,刀90的刀口108和刀刃110可以位于供给带引导器40的远末端42内。 It may also be at least partially accommodated in the blade 108 in the staple cartridge 30, shown in Figure 8, the knife 90 and cutting edge 110 of knife 108 may be located within the distal end 42 is supplied with the guide 40.

[0079] 使用者开动手柄8上的一个或更多控制器来开动端部执行器4。 [0079] the user start a handle 8 or more controllers to actuate the end effector 4. 最终,杆104通过任何合适的机制或方法向近处移动。 In the end, the rod 104 moves proximally through any suitable mechanism or method. 例如,杆104近末端延伸至手柄8,手柄8内的装置将杆104向近处移动,该装置可以通过释放手柄8内储存的能量开动。 For example, near the end of the rod 104 extends to the handle 8, the handle means 8 rod 104 moves proximally, the device may be released by the energy stored within the handle 8 start. 直线移动杆104的装置是标准使用的方法,但任何合适的装置都可以使用。 It means linear movement of the rod 104 is a standard method used, but any suitable means can be used. 向近处移动的杆104通过杆104和模块84上的突出98间的连接使模块84向近处移动。 Proximally moving the lever 104 is connected to a rod 98 84 104 and module by module 84 projecting move proximally. 模块84向近处的运动继而使模块84连接的楔部件72和刀90向近处运动。 Module 84 and then to a nearby sports module 84 is connected so that the wedge member 72 and the knife 90 to near sports. 或者,杆104也可以通过旋转而不是通过向近处拉回,或者通过即旋转又向近处拉回而促使模块84向近处运动。 Alternatively, by rotating the rod 104 may be near but not through the back, or by rotating the ED that is near the back which prompted module 84 proximally movement.

[0080] 如果使用滑动的夹具160,且夹具还没有滑动到第二位置,其中上夹具162和供给带16接触,则滑动夹具160被移动到第二位置。 [0080] If the slide clamp 160 and the clamp has not slid into a second position, wherein the upper jig 162 and the supply belt 16 contacts the slide clamp 160 is moved to the second position. 这种移动包括将上夹具162向近处滑动和/或将下夹具164向远处滑动。 This movement involves sliding the slide clamp 162 proximally and / or the lower jig 164 to the distance. 在滑动过程中,上夹具162的舌状物168沿着下夹具164的狭槽166滑动。 In the sliding process, the jig 162 on the jig 166 tongue 168 of the slide 164 along the lower slot. 随着上夹具162和/或下夹具164的滑动,凸轮表面170,172相互衔接使上夹具162的上表面向上移动,并和供给带16相接处。 With the upper jig 162 and / or the lower jig slide, the cam surface 164 of 170, 172 interface between the upper surface of the upper jig 162 is moved upward, and and supply with 16 phase at. 这种接触能在楔74和缝钉18接触过程中进一步稳定供给带`16。 Such contact can be further stable supply with the wedge 74 and the staple 18 contacts during `16.

[0081] 楔部件72向近处的运动引发每一条楔74向近处的运动,继而使缝钉18部署出去。 [0081] wedge member 72 is raised to the movement of each wedge 74 near the vicinity of the movement, and then deploy the staples out of 18. 需要澄清的是,我们描述了单条楔74部署对应排26中一个或更多个缝钉18,楔74最初远离对应的基本成直线的排26中的缝钉18,楔74运动轨迹与对应排26基本平行或共线,随着楔74向近处运动,楔74的第一表面79与对应排中最远的缝钉18相接触。 To be clear, we describe the deployment of a single wedge 74 corresponds to a row of 26 or more staples 18, wedge 74 away from the corresponding first substantially straight row 26 of staples 18, wedge 74 and the corresponding trajectory row 26 is substantially parallel to or collinear with the wedge 74 to near the sports, the first surface 79 of the wedge 74 is in contact with the corresponding row of staples 18 farthest. 如图5所示,第一表面79和缝钉18间的接触使缝钉18受力。 As shown in Figure 5, the contact surface 18 of the first 79 and staples 18 staples force. 因为第一表面79带有一个向上指向远处的角度,使缝钉受到向近处和向上的力。 Because the first surface 79 with an upwardly directed angle distance, the staples being proximally and upward force. 另外,缝钉18受到的力产生一关于使缝钉18与供给带16相连的标突28的力矩,该力矩使缝钉18在标突28周围旋转,从而使缝钉18自由端22向上运动,穿过外壳60的顶板66上对应的隙缝67进入血管148。 In addition, the staple 18 by the force generating a mark on the staples 18 and 16 connected to the torque supply with sudden 28, the moment marked the staples 18 rotating around projection 28 so that the free end 22 of the staple 18 upward movement on through the housing 60 of the top plate 66 corresponding aperture 67 into the blood vessel 148. 或者,如果没有使用标突28,缝钉18受到的力在缝钉18和供给带16连接位置产生一个力矩。 Or, if you do not use standard projections 28, 18 by the force of the staples in the staple position 18 and the supply 16 are connected to produce a torque band. 在楔74运动过程中,供给带16可以是基本保持原位,或者是通过例如和对应突出部50的摩擦而被动地保持原位,或者是通过例如位于手柄8,杆轴6和/或端部执行器中的制动器或夹紧装置(未显示)而主动地保持原位。 During movement of the wedge 74, 16 can be supplied with a substantially remain in place, for example, or by a corresponding projecting portion 50 and the friction of passively remain in place, for example, or by the handle 8 is located, the lever shaft 6 and / or end The brake actuators or clamping device (not shown) and actively remain in place.

[0082] 楔74继续向近处运动,继续对缝钉18施力,从而在标突28上产生力矩。 [0082] Wedge continued to near 74 movement continue to staple 18 is biased so as to generate torque in standard projection 28. 随着缝钉18的自由端22向上旋转,其完全穿透血管148,之后与砧32的下表面接触。 With the free end 22 is rotated upward staple 18, completely through the vessel 148, after contact with the lower surface 32 of the anvil. 任选地,砧32在与缝钉18自由端22接触的位置可带有一个标准的使缝钉弯曲的结构(未显示)。 Optionally, the anvil 32 and the staple 18 at the free end 22 of the contact position can be provided with a standard configuration so that the curved staple (not shown). 随着缝钉18的自由端22与砧32接触,缝钉18在标突28周围的旋转导致自由端22向上及远处运动。 With the free end 22 of the staple 18 in contact with the anvil 32, staples 18 in standard projection 28 around the rotation causes the free end 22 and distal movement upwards. 但是,缝钉18自由端22和砧32的接触阻碍缝钉18自由端22继续向上运动。 However, the staple 18 contacts the free end 22 and the anvil 32 of 18 staple impede the free end 22 continues to move upward. 因此,缝钉18的自由端22沿着砧32下表面和/或使缝钉弯曲的结构向远处运动。 Thus, the free ends 18 of the staple anvil 32 along the lower surface 22 and / or staple a bent structure to the distant movement. 该运动使缝钉18与自由端22连接的脚20弯曲或变形,闭合缝钉18。 The campaign staples 18 and the free end 22 of the connection pin 20 are bent or deformed staple 18 closure. 缝钉18可以由塑性变形材料如不锈钢制成,这样缝钉18的变形可以是塑料变形。 As staple 18 may be made of stainless steel material to plastic deformation, so that deformation of the staple 18 may be a plastic deformation. 或者,至少缝钉18的局部可弹性变形或超弹性变形。 Alternatively, at least partially staple 18 is elastically deformable or superelastic deformation.

[0083] 随着楔74继续向近处移动,楔74的顶端82靠近缝钉18,该缝钉18可能已经顶着砧32完全或基本变形了。 [0083] As the wedge 74 continue to move to near the top 82 of the wedge 74 near staple 18, the staples 18 against the anvil 32 may have been completely or substantially deformed. 或者,缝钉18变形的过程持续到了楔74的顶端82与缝钉18的连接点。 Alternatively, the staple 18 deformation process continues until the top of the wedge 74 connection points 82 and 18 of the staple. 当顶端82接触或靠近缝钉18时,施加在缝钉18上的力的方向主要是向上的。 When touching or near the top 82 staples 18:00, direction of the force exerted on the main staple 18 upward. 另外,这个力作用于连接缝钉18和供给带16的标突28上或其附近,这个力将缝钉18从供给带16上剪下,断开或分离开来。 In addition, the force is used to connect the staple 18 and 16 is supplied with a standard projection 28 or near, this force will cut 16 staples 18 from the supply belt, disconnected or separated. 标突28的构造使楔74顶端82或楔74靠近顶端82的部分施加的力足以将缝钉18从供给带16上剪下,断开或分离开来。 Construction standard projection 28 so that the wedge 74 to the top 82 or wedge 74 near the top portion 82 of the force applied is sufficient to supply the staples 18 from 16 with a cut, broken or separated. 当缝钉18和/或标突28在其相交点或相交点附近带有一个削弱区域时,缝钉可以在这个削弱区域上从供给带16剪下,或与其断开或分离开来。 When the staple 18 and / or marked with a weakened area projection 28 near its intersection point or intersection point, the staple in this weakened area can be supplied with 16 cut from, to or disconnected or separated. 顶端82也可以主动地将缝钉18完全推出,驱出或排出外壳60。 The top 82 may take the initiative to complete the introduction of the staple 18, driven out or discharge housing 60. 或者,缝钉18可以是被动地从外壳60排出,这也就是说缝钉18不是被主动驱出外壳60,而是从外壳60内简单的释放出来的,且能够脱离开来。 Alternatively, the staple 18 may be passively discharged from the housing 60, which means that the staples 18 not to be driven out of the housing 60 initiative, but simply from the housing 60 is released, and can come from opening. 在这时,变形的、被排出的缝钉18位于血管148上。 At this time, the deformation is discharged staple 18 is located on the vessel 148. 缝钉18的易断性能够使其稳固地可靠地固定在供给带16上,继而被固定在缝钉盒30内,同时也能够可靠地分离和部署。 Frangible of staples 18 so that it can be securely fixed firmly on the supply belt 16, in turn is fixed within the staple cartridge 30, while it is possible to reliably separate and deploy. 第二表面80基本上不接触缝钉18或标突28。 The second surface 80 is substantially not in contact with the staple 18 or 28 standard projections. 或者,第二表面80的形状或构造能够有助于缝钉18的变形和/或排出。 Alternatively, the second surface 80 of the shape or configuration can contribute to sew deformed staple 18 and / or discharge.

[0084] 另外,楔74的构造可以如图28所示。 [0084] In addition, the wedge 74 may be constructed as shown in Fig. 如上所述,楔74的第一段140的形状可被制成有助于缝钉18的部署,楔74的第二段142的形状可被制成有助于剪下或分离供给带16上的缝钉18。 As described above, the shape of the first section 140 of the wedge 74 may be formed to deploy staples 18, 74 of the wedge shape of the second section 142 may be formed or cut separator contribute to feeding the tape 16 helps 18 staples. 基本如上所述,当楔74相对于缝钉18移动且接触缝钉18时,楔74的第一段140碰到缝钉18,并对其施加一向近处向上的力。 Substantially as described above, when the wedge 74 to move relative to the staple 18 and the contact staples 18:00, the first paragraph of the 140 hit the wedge 74 staples 18, and its vicinity has been an upward force. 第一段140可被制成一形状,其可以使缝钉18在楔74第一段140`移动离开其接触点之前基本完成成形。 The first stage 140 can be formed into a shape which allows the staple 18 140` in the first paragraph before the wedge 74 is moved away from the contact point of the basic completion of forming. 第二段142具有便于使缝钉18与供给带16分离的形状。 Second section 142 has easy staples 18 and 16 is supplied with a separate shape. 随着楔74继续向近处移动,第一表面140与基本形成的缝钉180分离,第二表面142移动且接触基本形成的缝钉18。 As the wedge 74 to continue to move near the first surface 140 180 Separation and staples basic form, the second surface 142 mobile and basic staples contacts 18 formed. 当缝钉18的形状如图25-27所示时,在缝钉18基本形成后,缝钉18的隆起136的朝向总体向下且位于第二表面142的运动轨迹上。 When the shape shown in FIG. 18 25-27 staple, staple 18 after basic form, ridge 18 of 136 staples toward the overall downward and located on the second surface of the trajectory 142. 因此,随着第二表面向近处滑动,隆起部136受到一个向上的力,这个力将形成的缝钉18从供给带16上剪下,断开或分离开来。 Thus, with the sliding surface to near the second protuberance 136 by an upward force, this force will be formed staple 18 from the supply belt 16 cut, broken or separated.

[0085] 当缝钉18与供给带16分离后,楔74可以继续向近处移动。 [0085] When the staple 18 and 16 is supplied with a separate, wedge 74 can continue to move proximally. 随着它向近处移动,它碰到另一个缝钉18,且使该缝钉18变形,将该缝钉18和供给带16分离开来,其方式与上述方法基本相同。 As it moves to the vicinity, it encountered another staple 18 and 18 so that the deformation of the staples, the staple 18 and supplied with 16 separated, which is essentially the same manner as described above. 楔74的长度可以足够长,其可以在楔74使一个缝钉18变形到一定程度但还没有使它从供给带16上分离出来时,楔74已经和下一个最远的缝钉18衔接且开始使之变形。 Wedge length 74 may be long enough, it can make a staple in the wedge 74 18 deformed to a certain extent, but not that it is separated from the feed belt 16, the wedge 74 has and the next furthest convergence and staple 18 began to deform. 或者,楔74的长度可以足够短,使它在和下一个最远的缝钉18衔接且开始使之变形前,完全使一个缝钉18变形和分离。 Alternatively, the length of the wedge 74 may be short enough to make it a staple farthest Cohesion in and under 18 and begins to deform before making a staple 18 is completely deformed and separation.

[0086] 可以控制模块84在纵向上沿着一定距离移动每一楔部件72和对应的楔74,从而使每一楔74在驱动过程中部署一定数量的缝钉18。 [0086] The control module 84 can move in the longitudinal direction along a certain distance of each wedge member 72 and the corresponding wedge 74 so that each wedge 74 deploy a certain number during driving 18 staples. 结果是,如图29所示,血管148或其它组织上每一条缝钉线146的长度都是固定的。 As a result, as shown in Figure 29, the blood vessel 148 or 146 every seam staple line length on other tissues are fixed. “缝钉线”是指排26中缝钉18在其部署在组织上后的集合。 "Staple line" refers to the collection of row 26 of staples 18 after its deployment in the organization. 模块84可在控制下以任何合适的方式沿着固定的长度移动。 Module 84 is movable along a fixed length under control in any suitable manner. 例如,杆104在内切割器2的每一次驱动过程中都可以向近处移动固定的长度。 For example, the rod 104 of the inner cutter 2 during each drive can be moved proximally a fixed length. 排26中固定数量的缝钉18可以集合在一起且由供给带16上的空白区域与邻近的缝钉18组隔开,其中空白区域的长度可以是任何合适的长度。 A fixed number of rows 26 of staples 18 may be grouped together and fed by a blank area on the tape 16 spaced from the adjacent staple 18 group, wherein the length of the blank area may be any suitable length. 空白区域使楔74的纵向长度可以足够长,从而使楔74在对上一个缝钉18仍然进行变形和/或排出时就能够衔接下一个缝钉18且开始使其变形。 A blank area of the longitudinal length of the wedge 74 may be long enough so that the wedge 74 to 18 is still a staple deformation and / or the discharge will be able to join the next staple 18 and begins to deform. 因此,当楔74向内侧移动至碰到空白区域时,没有缝钉18被楔74变形,从而使该组中每一个缝钉18都能完成变形且不会使接下来的缝钉被部分变形。 Therefore, when the wedge 74 to move inward across an empty area, no staple 18 is deformed wedge 74 so that the group each staple 18 can be completed without causing subsequent deformation is partially deformed staples . 但是,楔的长度也可以很短,使它与楔74衔接且开始变形下一个最远处的缝钉18前,完全变形且分离一个缝钉18。 However, the length of the wedge may be very short, making it the wedge 74 and the adapter 18 before the start of the next most distant deform staples, and separation of a fully deformed staple 18.

[0087] 或者,模块84可以选择性的控制楔部件72和对应的楔,使其在纵向上沿着一定距离移动,从而使一定数量的缝钉18在驱动期间被楔部署。 [0087] Alternatively, the control module 84 may selectively wedge member 72 and the corresponding wedges, to move along a certain distance in the longitudinal direction, so that a certain amount of staple 18 during the driving wedge being deployed. 这样就可以改变和选择血管148或其它组织上缝钉线146的长度。 So that you can change and select the length of the staple line 146 on the blood vessel 148 or other tissue. 模块84可以以任何合适的方式进行选择性地控制。 Module 84 may be selectively controlled in any suitable manner. 例如,在内切割器2驱动期间,使用者可以将杆104向近处移动一选择的距离。 For example, the inner cutter drive period 2, the user can move the rod 104 a selected distance proximally. 杆104在手柄8驱动下沿着选择的距离移动,手柄8也可以设置成能够接收使用者对选择距离的输入。 Rod 104 to move along a selected distance driven by the handle 8, the handle 8 may be arranged to be able to receive input from a user selection. 手柄8可以带有任何能够控制杆104纵向移动距离的合适的结构。 8 may be able to handle with any longitudinal movement of the control rod 104 structures suitable distance. 例如,手柄8可以包括一个与杆104连接的分档马达,该马达使杆104能从一组不同长度中选择某一长度。 For example, the handle 8 may include a rod 104 connected to a motor sub-file, the rod 104 of the motor from a set of different lengths of a selected length. 再例如,手柄8包括一个机械制动器,使用者可以移动该制动器,当杆104碰到机械制动器时停止向近处运动。 As another example, the handle 8 comprises a mechanical brake, the user can move the brake, to stop the movement when the lever 104 near encounter mechanical brake. 也就是说,杆104可以至少在可选择的最长的缝钉线146上带有弹簧或者有偏向性,机械制动器用于使杆104的运动停止在一小于最长的可以选择的缝钉线146的距离之内。 That is, the rod 104 may be at least in the alternative longest staple line 146 with a spring or biased, mechanical brake is used to stop the movement of the lever 104 in a less than the longest line of staples that can be selected within 146 distance. 因为楔74运动的距离在每一次驱动中都可能是不同的,并且使用者是可以选择的,有利的是,供给带16都没有空白区域。 Because the distance movement of the wedge 74 in every drive is likely to be different, and the user is able to choose, it is advantageous that the supply belt 16 are not white space. 另外,有利的是,楔的长度可以很短,足以使它在衔接并开始变形下一个最远处的缝钉18前,完全变形并分离一个缝钉18。 Further, it is advantageous that the length of the wedge can be short enough so that it starts at the convergence and deformation of the next most distant staple 18 before a fully deformed staple 18 and separates.

[0088] 如图11-12和14-17所示,随着模块84向近处移动,它也移动了与模块84通过弯勾92或刀90近末端其它结构连接的刀90。 [0088] As shown in Figure 11-12 and 14-17, with the module 84 to move proximally, it also moves the blade and curved hook module 84 by 92 or 90 near the end of the knife 90 connected to other structures. 随着刀90向近处移动,位于砧32和缝钉盒30间的组织被切割。 With the knife 90 to move proximally located anvil 32 and staple cartridge 30 of tissue is cut. 在刀90切割组织的同时,缝钉18也被变形并排出。 90 knife cutting tissue, while also being deformed staple 18 and discharged. 随着刀90从初始位置向近处移动,刀90的刀口108底部衔接并撑起夹持器112远末端的斜部116。 With the knife 90 moves from the initial position to near 108 at the bottom of the knife blade 90 and hold up the convergence of the distal end of the holder 112 of the ramp portion 116. 随着刀口108撑起斜部116,至少刀口108的刀刃110的局部移动至外壳顶板66之上,并开始切割砧32和缝钉盒30间的组织。 With the blade prop up the ramp portion 116 108, local moving at least 108 knife blade 110 to 66 over the shell roof, and start cutting anvil 32 and staple tissue box 30 in. 当刀口108到斜部116顶部后,其随着模块84继续向远处推动刀90而继续沿着延伸部114的上表面向远处移动。 When the blade 108 to the top of the ramp section 116, which increases with the distance module 84 continues to push the knife 90 and continue along the upper surface of the extended portion 114 moves to the distance. 至少刀口108的局部可以随着刀90向外拉出而在外壳内壁68间滑动。 At least 108 local edge with the knife 90 can pull out and slide in between the inner wall of the housing 68. 或者,刀口108可以完全位于外壳内壁68的上面,或者以其它方式移动。 Alternatively, the blade 108 may be located entirely above the shell wall 68, or otherwise move. 或者,可以去除斜部116和延伸部114。 Alternatively, you can remove the ramp portion 116 and the extending portion 114. 刀口108的刀刃110可以通过其它方式控制上升至外壳60的顶板66以上。 Knife blade 108 110 may be raised to the housing 60 of the top plate 66 by other means control over. 或者,可以控制刀口108基本只在纵向上移动,而在垂直方向上基本不运动。 Alternatively, you can control blade 108 basic moves only in the longitudinal direction and in the vertical direction substantially no movement.

[0089] 在一定数量或选择数量的缝钉18被变形和排除后,模块84停止运动。 [0089] In a certain number or select the number of staples 18 is deformed and removed, module 84 stops moving. 当模块84停止运动后,模块84,楔74和刀口108均处于最后位置。 When the module 84 to stop the movement, module 84, wedge 74 and the blade 108 are in the last position. 刀口108的尺寸和形状能够使刀口108在其处于最后位置时完全切割砧32和缝钉盒30间的组织。 The size and shape of the blade 108 enables the blade 108 is in its final position in the organization completely cutting anvil 32 and staple cartridge 30 in. 在最后位置时,至少一条楔74和/或刀口108接近外壳中对应的接收空间70。 In the final position, at least one wedge 74 and / or the blade housing 108 near the corresponding receiving space 70. 或者,楔74和/或刀口108仍留在外壳60对应接受空间70中的最后位置。 Alternatively, the wedge 74 and / or blade 108 remain in the housing 60 corresponding to the receiving space 70 in the final position. 在一定数量或选择数量的缝钉18被变形和排除后,刀口108的刀刃110已经横切砧32和缝钉盒30间的组织,端部执行器4回复到打开位置,释放组织。 In a certain number or select the number of staples 18 is deformed and removed, knife blade 108 110 has cross-organizational anvil 32 and staple cartridge 30, the end effector 4 to return to the open position, release tissue. 如图29所示,当所述组织为血管时,血管148被切割成两段,其中每段末端附近均带有错开的缝钉18排,形成缝钉线。 29, when the tissue is vascular, vascular 148 is cut into two sections, wherein all near each end with 18 rows of staggered staples, staple lines formed. 每条楔74驱动对应排26中的缝钉18,如所述的缝钉18和外壳60顶板66的隙缝67错开排布。 Each wedge 74 drives the corresponding row 26 of staples 18, the staple 18 as the housing 60 and the top plate 66 of the slit 67 staggered arrangement. 错开缝钉线146中缝钉18排26有助于血管148末端止血,因为如果缝钉18排26不错开则漏道将更长,更弯曲。 Staggered staple lines 146 in row 26 of staples 18 148 end of the vessel to help stop the bleeding, because if 18 rows of staples 26 is a good open-drain path will be longer and more curved.

[0090] 在内切割器2驱动的另一个例子中,楔74最初靠近对应排26中的缝钉18,且楔74向远处移动而不是向近处移动以部署排26的一个或更多缝钉18。 [0090] Another example of the second drive, including a cutter, the wedge 74 is close to the corresponding first row 26 of staples 18, and wedge 74 moved distally than proximally move to deploy a row of 26 or more 18 staples. 楔74向远处的运动可以通过例如将杆104向远处方向移动实现。 74 wedge to the distant sports for example, by moving the lever 104 to achieve the distance direction. 当楔74向远处移动且部署缝钉18时,楔74的第一表面79和第二表面80为了能适当部署缝钉可以具有不同形状。 When the wedge 74 is moved distally to deploy staples and 18:00, the first surface 74 of the wedge 79 and the second surface 80 in order to properly deploy staples may have different shapes. 另外,缝钉18相对于供给带16带有向后的方向,从而使每一个缝钉18的自由端22远离缝钉18和供给带16连接部位。 Further, with respect to the staple 18 is supplied with the belt 16 rearward direction, so that each staple 22 remote from the free end 18 and the staple 16 is supplied with the connecting portion 18. 为了变形缝钉18,且使其从供给带16上分离,缝钉盒30的其它操作的顺序与以上所述的顺序也大致相反。 To Deformation nail 18, and it is separated from the feeding belt 16, the order of the staple cartridge 30 and the other operations sequence described above is roughly the opposite.

[0091] 然后,内切割器2可以再次部署缝钉而不需将端部执行器4从病人体内取出,更换钉仓或者其它一次性缝钉盒或者从内切割器2外部填充端部执行器4。 [0091] Then, the cutter 2 can deploy staples without the end effector 4 again removed from the patient, or to replace the cartridge or other disposable staple cartridge 2 from the external filling cutter actuator end 4. 为此,手柄8在端部执行器4回到打开位置后可以驱动回复模块84至初始位置。 To this end, the handle portion of the actuator 8 at the end of 4 return to the open position after the response module 84 may be driven to the initial position. 或者,模块84在端部执行器4回到打开位置后,或在其它时间回到初始位置。 Alternatively, the module 84 at the end of the actuator 4 return to the open position, or at other times to the initial position. 杆104可以向近处方向移动使模块84回到其初始位置。 Rod 104 can be moved proximally so that the direction of the module 84 back to its initial position. 或者,模块84可以以任何其它方式回到其初始位置。 Alternatively, the module 84 may be in any other way back to its initial position. 再例如,模块84可以偏向远处,从而可以释放杆104,使模块84自动回到初始位置。 As another example, the module 84 can be biased away, thereby releasing the lever 104, so that the module 84 automatically returns to the initial position. 例如,模块84可以偏向近处,从而使杆104不会向近处移动,部署,排出缝钉18。 For example, the module 84 can be biased near, so that the rod 104 is not moved proximally, deployment, discharging staples 18. 如果这样,杆104可以用于将模块84向远处推回至初始位置,并保持在初始位置。 If so, the lever 104 can be used to push back the module 84 to the distance to the initial position, and held in an initial position. 或者,模块84可以通过任何合适的方式回到其初始位置。 Alternatively, the module 84 can return to its initial position by any suitable means. 随着模块84移回至初始位置,楔74和刀口108移回至初始位置,逆转楔74和刀口108在端部执行器4驱动过程中的移动轨迹。 With the module 84 is moved back to its original position, the wedge 74 and the blade 108 moves back to its original position, reverse the wedge 74 and the blade 108 moves the track at the end of the actuator 4 drives the process. 或者,楔74和/或刀口108可以通过其它途径移动和/或沿着不同的轨迹回到初始位置。 Alternatively, the wedge 74 and / or the blade 108 may be moved and / or returned to the initial position along a different trajectory through other means. 因为在楔74轨迹中的缝钉18已经部署出外壳60,楔74可以回到它们初始位置而基本不接触缝钉。 Because the wedge 74 tracks 18 staples have been deployed out of the housing 60, the wedge 74 can return to their initial positions and basic staples are not in contact. 另外,因为端部执行器4已经放开组织,刀口108回到初始位置而基本不接触组织。 Further, since the end actuator 4 has been released tissue, blade 108 returns to the initial position without substantial contact with the tissue.

[0092] 到这时,楔74和刀口108在其初始位置。 [0092] By this time, the wedge 74 and the blade 108 in its initial position. 之后,如果供给带16在之前驱动端部执行器4过程中的运动受到滑动夹具160的阻碍,那些滑动夹具回到第一位置,从而使上夹具162不再阻碍供给带16。 After 4 process if the supply belt 16 before the driving end of the actuator movement hindered by the slide clamp 160, that the slide clamp to the first position, so that the upper jig 162 no longer hinder the supply belt 16. 这种运动可包括上夹具162向远处滑动和/或下夹具164向近处滑动。 This movement may include jig 162 to and / or in the distance slide jig 164 is slid proximally. 在滑动中,上夹具162的舌状部168沿着下夹具164的狭槽166滑动。 In the slide, the upper jig tongue along the lower jig 162 168 166 164 of the slide slot. 随着上夹具162和/或下夹具164的滑动,凸轮表面170,172相互衔接使上夹具162的上表面向下移动,而不接触供给带16,使供给带16向前运动。 As the upper jig 162 and / or the lower jig slide, the cam surface 164 of the upper surface 170, 172 so that the interface between the upper jig 162 is moved downward without contacting the feeding belt 16, the forward movement of the supply belt 16. 如果手柄8、杆轴6或端部执行器4带有不同或附加的限制装置,如刹车或离合器,则释放该装置。 If the handle 8, the lever shaft 6 or the end effector 4 with different or additional restriction device, such as a brake or a clutch, the apparatus is released. 之后移动供给带16,将新的缝钉18推进至外壳60。 After moving the supply belt 16, the new staple 18 advance to the housing 60. 供给带16的这种运动统称为推进供给带16,尽管事实上一些或全部供给带16在推进过程中可以向远处之外的方向推进。 This movement is supplied with 16 collectively to promote the supply belt 16, despite the fact that some or all of the supply belt 16 can advance toward the far outside in advancing the process. 供给带16可以以任何方式推进。 Supply belt 16 can advance in any way. 例如,如上所述,供给带16围着每一个突出部50,沿着带有直线起点且具有远处方向的路线,之后沿着对应突出部50的表面弯曲,之后沿着基本直线具有近处方向的路线,使对应供给带16的运动方向总体上是从远处至近处。 For example, as described above, each of the supply belt 16 around protrusion 50, along a straight line with a starting direction and has a distance, then along the curved surface corresponding to the projecting portion 50, along a substantially straight line after having Vicinity line direction, so that the supply corresponds with the direction of movement 16 of the whole from a distance to near. 供给带16在突起部50下面或其附近的部分可以向近处缩回,从而将位于突出部50上面或附近的供给带16部分向远处拉动,将新的缝钉18推入外壳60。 Supplied with 16 or near 50 below portion may be retracted proximally protruding portion, which will be located on or near the supply part of the protrusion 50 with 16 to pull away, the new staple 18 pushed into the housing 60. 供给带16位于突出部50下面和附近部分可以以任何合适的形式向近处拉回。 Supplied with 16 at 50 below and vicinity protrusion may proximally back in any suitable form. 例如,供给带16可以部分延伸至手柄8,其中的传动装置,滚柱或其它装置对供给带16直接施力。 For example, the supply belt 16 can be extended to handle In part 8, wherein the drive means, roller or other means supplied with 16 direct biased. 再例如,供给带16可以连接于延伸至手柄8的中间结构或装置,并且使施力于其上。 As another example, the supply 16 may be connected with the handle to extend to an intermediate structure or device 8, and the urging thereon. 如图25所示的另一实施例,供给带16的一个或更多个开口132与一个或更多个齿轮,栓或其它装置衔接,从而使与开口132的衔接可以用于推进供给带16。 Another embodiment shown in FIG. 25 is supplied with a 16 or more openings 132 with one or more gears, bolts, or other means of convergence so that the convergence of the opening 132 can be used to advance the supply belt 16 . 再例如,可以使用任何合适的装置,结构或方法来移动供给带16,从而将新的、未部署的缝钉18推入外壳60。 As another example, you can use any suitable means, structures, or methods to move the supply belt 16, so that the new, non-deployment of the staple 18 pushed into the housing 60. 当供给带16可以基本直线运动,且未使用突出部50时,外壳60可以更长,且供给带16是简单的直线推进和缩回,从而将新的缝钉18推入外壳60内。 When the supply belt 16 may be substantially linear motion, and in use the protrusion 50, the housing 60 may be longer, and the supply belt 16 is a simple straight line advance and retract, so the new staple 18 pushed into the housing 60.

[0093] 供给带16可以在有或没有反馈信息的情况下推进。 [0093] supply strip 16 can advance the case with or without feedback information. 例如,使用分档马达或其它装置每次使供给带16推进一固定距离。 For example, the use of sub-file every time a motor or other means to promote the supply belt 16 a fixed distance. 当带有反馈信息时,供给带16根据反馈信息确定推进距离,该距离可以每次都不相同。 When with feedback information, supplied with 16 advancing from the feedback information is determined, the same distance can be different each time. 例如,可以设置针轮(未显示)以使用栓衔接供给带16的开口132,从而使供给带16的运动能够转动针轮。 For example, you can set the needle wheel (not shown) to use the supplied plug adapter opening 132 with a 16, so that the supply can be rotated with motion 16 pin wheel. 针轮的这种转动可以产生机械或电子反馈信息,该信息通过机械或电子方式传送到手柄8,从而能继续推进供给带16直至针轮旋转至一定量。 This rotation of the wheel can produce mechanical or electronic feedback information, the information is transmitted to the handle 8 by mechanical or electronic means, so that it can continue to advance until the belt 16 is supplied to a certain amount of wheel rotation. 用这种方法,针轮可以确认供给带16实际推进的位置,在这个位置上有未部署的缝钉18位于外壳60顶板66对应的隙缝67中。 In this way, the needle wheel can confirm the actual supply with 16 advanced position, in this position have not deployed the staple 18 located in the housing 60 corresponding to the top 66 in the slot 67. 反馈的另一实施例是端部执行器4末端可以安置一个或多个光感器(未显示),该一个或多个光感器可以决定供给带16推进的程度。 Another embodiment of the feedback is four-terminal end of the actuator can be placed one or more optical sensors (not shown), one or more optical sensors that can determine the extent of the supply belt 16 advance. 又例如,可以使用任何合适的装置产生反馈信息并通过机械,电子和/或数据的形式传送到合适的控制器,控制器可以设置在内切割器的手柄8中或其它部位。 As another example, you can use any suitable means to produce feedback information and transmitted to the appropriate controller by mechanical, electronic and or form / data, the controller can be set up, including the cutter handle 8 or other parts. 控制器可以是凸轮,集成电路,微处理器,模拟电路,数字电路,机械电脑或其它任何合适的控制器。 The controller may be a cam, integrated circuits, microprocessors, analog circuitry, digital circuitry, or any other suitable mechanical computer controller.

[0094] 楔74和刀口108处于初始位置,未部署的缝钉18位于外壳60顶板66上对应的隙缝67位置。 [0094] wedge 74 and the blade 108 in the initial position, the staple undeployed 18 located on the housing 60 of the top plate 66 corresponds to the position of the slot 67. 供给带16可以基本保持原位,或者被动地通过与对应突出部50的摩擦力保持,或者主动地通过手柄8、杆轴6和/或端部执行器4内制动器或离合器(未显示)的作用而保持。 Feeding strip 16 can remain substantially in situ, or passively by the frictional force corresponding to the projecting portion 50 is maintained, or actively by the handle 8, the lever shaft 6 and / or end effector 4 the brake or clutch (not shown) Role and maintained. 此时,端部执行器4被设置使其再次驱动,且处于基本如上所述的初始设置状态。 In this case, the end portion 4 is arranged so that the actuator driven again, and in the initial setting state substantially as described above. 这样,端部执行器4可以驱动多次而不需要通过能够进入病人体内的套针孔10或其它切口、结构或装置将端部执行器4取出。 Thus, the end portion of the actuator 4 may be driven by many times without the need to be able to enter the patient's body or other sets of pinhole slit 10, structure or device 4 will remove the end effector. 保留端部执行器4在病人体内而不通过能够进入病人体内的套针孔10或其它切口、结构或装置将端部执行器4取出可以理解为将端部执行器保留在病人体内。 4 to retain the end effector through the patient without entering the patient's body can be set pinholes or other notches 10, structure or device 4 will remove the end effector can be interpreted as the end effector remains in the patient. 内切割器2可以在病人体内驱动多次而不需要从病人体内取出,直至用完内切割器2内的缝钉18。 Endocutter 2 may drive many times without the need to remove from the patient in the patient's body until the exhausted endocutter 2 within 18 staples. 内切割器2的手柄8或其它位置上可以设置指示器,用于显示内切割器2中剩下的未部署的缝钉18数量。 The cutter 8 may be provided a handle or other location of the indicator 2, the cutter 2 is used to display the remaining staples 18 undeployed number.

[0095] 为了清除起见,以上通过单排26的缝钉18的部署和排出而大致描述了内切割器2的驱动过程,其中,部署和排出可以通过基本相同的方式应用于每排26缝钉18。 [0095] In order to remove reasons, more than a single row of staples 18 and 26 of the deployment discharged generally described the cutter drive process 2, wherein the discharge can be deployed and used in substantially the same manner by each row of staples 26 18. 以上描述的内切割器2的操作过程可基本适用于任何数量排26缝钉18在供给带16上的操作。 During operation of the above described cutter 2 can be applied to any number of basic row 26 of staples 18 on the operation of the supply belt 16. 也就是说,供给带16上带有两排26或超过三排26缝钉18的内切割器2可以基本通过上述方法驱动。 In other words, the supply belt 16 with two rows of 26 or 26 for more than three rows of staples endocutter 18 2 may be substantially driven by the above method. 无人操作内切割器和其操作 Unmanned endocutter and its operation

[0096] 如图12,13和28所示,楔74相对于缝钉盒30可以是固定的。 [0096] FIG. 12, 13 and 28, the wedge 74 relative to the staple cartridge 30 may be fixed. 例如,楔74可以通过简单的浇铸、切割、形成或制作成为供给带引导器40的一部分或者是端部执行器4的其它部件。 For example, the wedge 74 can be a simple casting, cutting, forming, or be part of the production or other components of the end effector 40 is supplied with a guide 4. 随着每一供给带16的推进,每排26最远处的未形成的缝钉18与固定的楔74接触。 With each advance supplied with 16 staples in each row 26 of the most distant of 18 is not formed in contact with the stationary wedge 74. 之后,供给带16并不停止而是继续运动。 Thereafter, the supply belt 16 does not stop but continued movement. 随着供给带16继续推进,供给带16和固定的楔74间的相对运动导致缝钉18变形,然后从供给带16分离,该过程与上述楔相对于基本固定的供给带16的运动为基本相同的方式。 With the supply belt 16 continues to advance, with the supply of relative movement of the wedge 16 and fixed 74 results in deformation of the staples 18, and then separated from the feed belt 16, the process described above with respect to a substantially fixed wedge feeding movement with 16 basic in the same way. 当楔74是固定时,端部执行器4并不沿着缝钉线纵向设置一排缝钉18,而是,端部执行器4随着供给带16推动缝钉18至对应的楔74时有次序的部署每一排26最远处的缝钉18。 When the wedge 74 is fixed, the end effector 4 is not disposed longitudinally along the line of staples in a row of staples 18, but, with the end effector 4 is supplied with 16 pushing the staple 18 to a corresponding wedge 74 orderly deployment of each row 26 of staples 18 farthest. [0097] 或者,对于一次性设备,与缝钉18具有相同数量的楔74被制作成端部执行器4的一部分,且均位于对应缝钉18的最近处或最远处。 [0097] Alternatively, the disposable device, with the staple 18 having the same number of wedge 74 is made into a portion of the end portion of the actuator 4, and are located in the corresponding staple 18 nearest or most distant. 随着供给带16向纵向移动,每一个缝钉18均接触对应的固定楔74,变形为闭合结构,之后从供给带16上分离下来。 With the supplied belt 16 to the longitudinal movement of each staple 18 in contact with both the corresponding fixed wedge 74 is deformed into a closed structure, is detached from the supply after the 16 band. 这样可以沿着缝钉线同时部署两个或更多个缝钉18,而不需要楔部件72。 This can simultaneously deploy two or more staples 18 along the staple line, without the need for the wedge member 72. 任选地,楔74在部署一缝钉18后可以自第一位置向下或其它方向运动,从而使供给带16可以被推进以将新的、未部署的缝钉18送到位,用于部署,之后楔74可以移动回其第一位置。 Optionally, the wedge 74 after deploying a staple 18 may be down from the first position or the other direction, so that the supply belt 16 can be pushed to a new, non-deployment of the staple 18 to the position, for deployment After the wedge 74 can be moved back to its first position.

[0098] 虽然我们已经对本发明作了详细叙述,但是本领域内普通技术人员可以对本发明做不同的修改和修饰或使用替代品,其仍属于本发明范围内。 [0098] While we have made a detailed description of the present invention, but of ordinary skill in the art may make various modifications of the present invention and modifications or the use of alternatives, which fall within the scope of the present invention. 本发明并不局限于以上有关结构、部件间关系和/或方法的详细描述或图片说明。 The present invention is not limited to the above related structure, the relationship between the components and / or methods detailed description or caption. 本申请摘要中的陈述和任何简要陈述仅仅是作为举例说明,他们不能被视为是对权利要求范围的限制。 The application summary statements and any brief statements are only by way of illustration, they can not be considered as limiting the scope of the claims. 另外,图片也只是作为例子并不是用于限定的。 In addition, the picture only as examples are not intended to limit the. 标题和小标题仅是为了阅读方便而已,其不应视为带有实际重要内容、意义或解释,也不应被视为有关任何特定标题的全部信息都包含在该标题之下。 The title and subtitle are only for ease of reading only, it should not be regarded as having real important part of the meaning or interpretation, nor should it be considered as full information on any particular title are included under this heading. 因此,本发明除了以下权利要求及其法定等同物以外不受任何内容的限制。 Accordingly, the present invention except for the following claims and their legal equivalents thereof is not limited to any content.

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